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In this study, we assessed a possible correlation of CD4 counts with the low-cost progression markers neopterin, β2-microglobulin (B2M), total lymphocyte count (TLC) and hemoglobin, and we investigated associations between progression markers and clinical parameters in HIV-1 seropositive Zambians. Of 147 HIV-1 seropositive patients presenting to an outpatient clinic in Lusaka, blood was taken for CD4 counts, serum progression markers and full blood count. A detailed clinical history and medical examination was taken at that point, and the patients were seen 3-monthly over the following 12 months. Further CD4 counts were taken after 6 and 12 months. Neopterin, B2M, lymphocyte count, and hemoglobin showed a strong correlation with CD4 count. Of the serum progression markers, neopterin was more sensitive than B2M to detect HIV related symptoms and to predict weight loss and death in the follow-up period. Lymphocyte count and hemoglobin were significantly lower in patients with oral candidiasis and those falling sick or dying in the follow-up period. Hemoglobin was also associated with past diarrhoea. When stratified by sex, the associations of hemoglobin were very strong in males, but weaker in females. In conclusion, neopterin and B2M correlate well with CD4 counts in this African population. Neopterin appears to be more sensitive for the clinical evaluation of the patients in this study. Hemoglobin might only be useful as a progression marker in male individuals.

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Journal article



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37 - 42