Neopterin and beta 2-microglobulin as serum markers in a placebo-controlled anti-HIV therapy trial

The purpose of this study was to evaluate the use of the biologic immune activation markers neopterin and beta 2-microglobulin in monitoring human immunodeficiency virus (HIV)-positive patients without acquired immunodeficiency syndrome (AIDS) treated with isoprinosine and placebo. Serum samples obtained at the commencement of study and samples obtained after 24 weeks were available from 277 HIV-positive patients in the Scandinavian multicentre isoprinosine trial. After 24 weeks' treatment, the concentrations of beta 2-microglobulin and neopterin had increased both in the isoprinosine group and the placebo group. However, in the isoprinosine group the relative increase within beta 2-microglobulin was significantly smaller. Within neopterin, the increase from baseline level was small and not significantly different from the change in the placebo group. The beta 2-microglobulin data might reflect a suppressive effect of isoprinosine on the HIV-induced activation of the cellular immune system. Because of the minor changes, there is no real evidence of neopterin and beta 2-microglobulin being valuable as surrogate markers in monitoring therapy effects of isoprinosine.