Search

Background: To establish the discriminatory value of ADA and beta 2M serum levels as markers of AIDS progression., Methods: We have followed quarterly during two years a cohort of 24 patients with HIV infection; 103 clinical and laboratory evaluations were done (CDC/93 classification). In each of those blood samples we determined ADA, beta 2M, IgG, IgA, IgM, and CD4+ and CD8+ lymphocytes., Results: 26 evaluations belong to cases that kept stable in the clinic category A or B, CDC/93, ("stables": ADA = 19.05 +/- 10.79 U/L; beta 2M = 2.95 +/- 1.1 mg/L); the remaining 77 evaluations are from patients who clinical progressed to AIDS ("progressors": ADA = 32.03 +/- 13.2 U/L; beta 2M = 4.74 +/- 1.94 mg/L). When we compared statistically (RSIGMA software) the ADA and beta 2M means of both groups (Student t) and the means of all the variables in a block (multivariate analysis: Hotelling T2), very significant differences were appreciated (p < 0.001)., Conclusions: ADA and beta 2M are significantly increased in serum of HIV infected patients who clinical progress to AIDS. ADA and beta 2M can be used as serum markers of AIDS progression with a mistaken classification probability in the discriminatory analysis of 0.25; this probability decreases to 0.06 when immunoglobulins and lymphocytes subpopulations are evaluated too.

The activity of adenosine deaminase was determined in 79 pleural effusions in order to evaluate the utility and reliability in diagnosing tuberculous effusions. The effusions were grouped by the etiology: 26 were tuberculous (group I); 22 were neoplastic (group II); 11 were pneumonic (group III); 10 were non-infections exudates of different causes (group IV); and 10 transudates (group V). Group I presented the higher median value of AD (MED = 81.92; DE: 29.02) the difference being statistically significant (p less than 0.0001) compared with the results of the other groups. We found 2 cases of pleural tuberculosis histologically demonstrated with AD levels under the amount of 40 U/L. In our experience, AD determination had a sensitivity of 92% and specificity of 94%; with a predictive value of 89% and a negative predictive value of 96%, this being considered useful but non specific of tuberculosis.