Diagnostic and Discriminatory Efficiency of Eight Serum Modified Nucleosides in HIV Infection and in At-Risk Subjects

Abstract

The aim of this study was to evaluate fluctuations in modified nucleoside levels in serum could be used in the diagnosis and monitoring of human immunodeficiency viral (HIV) infection. We used an HPLC technique to assay serum levels of eight modified nucleosides in three groups of patients: normal subjects, patients with HIV infection at various stages of the disease, and intravenous (i.v.) heroin users, HIV-negative. The mean levels of modified nucleosides in patients with HIV infection were 2 or 3 times higher than those of normal subjects, while they were only slightly increased in i.v. heroin users. With multivariate discriminant analysis we identified a panel of serum nucleosides that had a 92% diagnostic efficiency in the discrimination between HIV-positive subjects and i.v. heroin users, and a 96% diagnostic efficiency in distinguishing HIV-positive patients from normal subjects; this efficiency has been confirmed with a new group of incoming HIV-positive patients. Furthermore, we found that in HIV patients at stage II of the disease, classified according to the Center for Disease Control of Atlanta, those with the lowest values of the helper/suppressor (H/S) iymphocyte ratio showed the highest serum levels of modified nucleosides, and that there was a statistically significant inverse correlation between t⁶A (N⁶-threoninocarbonyl-adenosine), m¹I (1-methylinosine) and m² ₂G (N²N²-dimethylguanosine) levels and the H/S ratio.