Adenosine deaminase activity in cerebrospinal fluid of HIV-infected patients: limited value for diagnosis of tuberculous meningitis

Adenosine deaminase activity (ADA) determination in cerebrospinal fluid (CSF) is considered a specific test for the diagnosis of tuberculous meningitis. In order to study the variability of this marker in patients with different neurological disorders associated with HIV infection, and its utility f...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2004-06, Vol.23 (6), p.471-476
Main Authors: CORRAL, I, QUEREDA, C, MORENO, S, NAVAS, E, MARTIN-DAVILA, P, PEREZ-ELIAS, M.-J, CASADO, J.-L, PINTADO, V, COBO, J, PALLARES, E, RUBI, J
Format: Article
Language:English
Subjects:
Adenosine
Adenosine Deaminase - analysis
Adult
AIDS-Related Opportunistic Infections - diagnosis
Biological and medical sciences
Biomarkers - analysis
Cohort Studies
Cryptococcus
Cytomegalovirus
Female
Fundamental and applied biological sciences. Psychology
HIV
Human immunodeficiency virus
Human viral diseases
Humans
Infectious diseases
Male
Medical sciences
Meningitis
Microbiology
Middle Aged
Probability
Prognosis
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Tuberculosis, Meningeal - cerebrospinal fluid
Tuberculosis, Meningeal - diagnosis
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Adenosine deaminase activity (ADA) determination in cerebrospinal fluid (CSF) is considered a specific test for the diagnosis of tuberculous meningitis. In order to study the variability of this marker in patients with different neurological disorders associated with HIV infection, and its utility for the diagnosis of tuberculous meningitis in these patients, the ADA levels in 417 CSF samples from HIV-infected patients with neurological symptoms were reviewed. HIV infection, HIV-associated neurological disorders, and progressive multifocal leukoencephalopathy were not associated with elevated ADA in CSF. Among patients with meningitis, receiver operating characteristic curve analysis gave an optimal ADA cut-off point of 8.5 IU/l for the diagnosis of tuberculous meningitis, with 57% sensitivity, 87% specificity, and an area under the curve of 0.747 (similar to that for CSF glucose concentration). False-positive results were found in patients with neurological CMV disease and cryptococcal, lymphomatous, and probable candidal meningitis. The results of this study indicate that ADA determination in CSF has limited utility for the diagnosis of tuberculous meningitis in HIV-infected patients.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-004-1110-z