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Tryptophan concentrations increase in cerebrospinal fluid and blood after zidovudine treatment in patients with HIV type 1 infection

Journal article
Authors Magnus Gisslén
M Larsson
Gunnar Norkrans
Dietmar Fuchs
Helmut Wachter
Lars Hagberg
Published in AIDS Res Hum Retroviruses
Volume 10
Issue 8
Pages 947-51
Publication year 1994
Published at Institute of Internal Medicine, Dept of Infectious Diseases
Pages 947-51
Language en
Keywords Adult, Aged, Biopterin/analogs & derivatives/blood/cerebrospinal fluid, CD4 Lymphocyte Count, Female, HIV Infections/drug therapy/immunology/*metabolism, *HIV-1/metabolism, Homovanillic Acid/cerebrospinal fluid, Humans, Hydroxyindoleacetic Acid/cerebrospinal fluid, Immunoglobulin G/blood, Male, Methoxyhydroxyphenylglycol/cerebrospinal fluid, Middle Aged, Neopterin, Serotonin/blood, Tryptophan/*blood/*cerebrospinal fluid, Zidovudine/*therapeutic use
Subject categories Microbiology in the medical area


Cerebrospinal fluid (CSF) and blood concentrations of indoleamines and catecholamines were analyzed in 14 HIV-1-seropositive individuals before antiviral treatment with zidovudine, after 3-14 months of treatment, and, in 8 of the patients, also after 14-30 months. The median pretreatment concentrations of tryptophan in CSF and blood were low (224 ng/ml and 6.0 micrograms/ml, respectively), but an increase in these values by an average of 40% in CSF and 23% in blood was seen after 3-14 months of zidovudine treatment (p < 0.01) and remained undiminished after 14-30 months of treatment. No significant change was observed in the 5-hydroxytryptamine (5-HT, serotonin) level in blood or in the CSF concentrations of the 5-HT metabolite 5-hydroxyindoleacetic acid (5-HIAA) and the dopamine metabolite homovanillic acid (HVA). The CSF concentrations of the noradrenalin metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) had decreased by 12% on average (p < 0.01) by the time of the second follow-up, that is, after 14-30 months of zidovudine treatment. A decrease in neopterin during antiretroviral treatment correlated with an increase in tryptophan (p < 0.01). The data suggest that an association between decreased immune stimulation and reduced tryptophan degradation in patients treated with zidovudine.

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