The dynamics of neopterin level in patients with herpes zoster

Neopterin is a specific marker of cellular immunity and monocytes/macrophages activation. Correlation between serum neopterin levels and clinical features of herpes zoster is unknown.The objective of the study was to determine the concentration of serum neopterin in patients with herpes zoster.Methods: 55 patients with herpes zoster (30 HIV-positive and 25 HIV-negative) were included. Serum neopterin levels were measured three times during the observation period (before onset of treatment with acyclovir, on the 3rd day of treatment and after healing of skin lesions). The clinical course and dynamics of laboratory data were also evaluated.Results: The study showed that elevated serum neopterin levels were found in all patients with herpes zoster. Neopterin concentrations were significantly reduced during acyclovir treatment (from 30 (17; 32) to 12 (11; 27) nmol/L) (p = 0,0000001), but remained above the upper limit of normal by the time skin lesions were healed in most patients. Neopterin levels before and after treatment weren’t associated with HIV-status. Neopterin concentration was slightly higher in patients with HIV infection on the third day of observation only, that could reflect the abnormal immunoreactivity of this host. Neopterin levels in patients with varicella zoster viremia were higher compared to patients without viremia on the third day of treatment with acyclovir (23.5 (12,7; 30,0) and 12 (4,2, 24,5) nmol/L, respectively, p = 0,037).Conclusions: These results suggest that the dynamics of serum neopterin could be a marker of effectiveness of immune response in herpes zoster.