Urinary neopterin levels in acute viral hepatitis

Authors

  • Gilbert Reibnegger,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Ingeborg Auhuber,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Dietmar Fuchs,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Arno Hausen,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Gert Judmaier,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Christian Prior,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Ernst R. Werner,

    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
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  • Prof. Dr. Helmut Wachter

    Corresponding author
    1. Institute for Medical Chemistry and Biochemistry and Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria
    • Institute for Medical Chemistry and Biochemistry, University of Innsbruck, Fritz Pregl Str. 3, A-6020 Innsbruck, Austria
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Abstract

Elevated neopterin levels in blood or urine have been shown to be a marker for the activation of cell-mediated immunity in vitro and in vivo. To evaluate whether neopterin levels are elevated in patients with acute viral hepatitis, we measured urinary levels in 13 patients with hepatitis A, 26 with hepatitis B, 12 with non-A, non-B hepatitis, 8 with jaundice and/or cholestasis due to biliary and pancreatic disorders and 3 with alcoholic hepatitis and in 62 apparently healthy HBsAg carriers. Neopterin levels in patients with virus-induced hepatitis were significantly higher than those in patients with other diagnoses. Urinary neopterin levels were above normal in 49 of 51 patients with viral hepatitis and elevations during the course of hepatitis showed a pattern similar to that of the usual liver biochemical tests, suggesting that neopterin levels were related to the clinical activity of the viral disease. In patients with non-viral biliary and hepatic disorders, neopterin levels were usually normal and did not correlate with other liver biochemical tests. These findings suggest that cell-mediated immune mechanisms are activated during viral hepatitis and that neopterin measurement may be of value as an additional surrogate marker for non-A, non-B hepatitis.

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