Neopterin Production, Degradation of Tryptophan and Neurologic Impairment in Human Immunodeficiency Virus Infection

Neurologic impairment In human immunodeficiency virus (HIV) infection may be related to metabolic factors in addition to a direct effect of HIV in the brain. An immune-enhanced tryptophan catabolism has been described in HIV infected patients that may contribute to neurologic/ psychiatric symptoms. In 41 HIV-infected patients we studied the serum and cerebrospinal fluid concentrations of interferon-γ, neopterin, tryptophan and kynurenine in comparison to determinations of neurologic and psychiatric abnormalities as measured by a mental test and computerized tomography. Serum concentrations of interferon-γ, neopterin, and kynurenine were increased, whereas tryptophan levels were de creased in patients. Similarly, cerebrospinal fluid concentrations of neopterin and kynurenine were increased in the majority of patients compared to normal values. Significant relations existed between serum neopterin, tryptophan and its degradation product kynurenine and neurologic parameters. In cerebrospinal fluid , concentrations of neopterin but not of the other parameters tested were related to the mental state of patients. Our study demonstrates that systemic immune activation and its influence on tryptophan metabolism are related to neurologic disease in HIV patients. Intrathecal alterations of tryptophan and kynurenine appear to be less important.

Abstract licence: CC BY-NC-ND

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