Influence of folate serum concentration on plasma homocysteine levels in HIV-positive patients exposed to protease inhibitors undergoing HAART.
BACKGROUND
Homocysteinemia (Hcy) increase and risk factors in HIV-positive patients are not clear yet.


METHODS
HIV-positive patients on stable highly active antiretroviral therapy (HAART) regimens for at least 6 months were enrolled in this cross-sectional study. Among other factors, vitamin B12, folate and length of exposure to protease inhibitors (PIs) were evaluated for their possible correlation with hyper-Hcy (>13 micromol/l in females; >15 micromol/l in males) by logistic regression analysis.


RESULTS
Ninety-eight HIV-positive patients were recruited. Twenty-eight (28.6%) had hyper-Hcy. Length of exposure to antiretroviral therapy and PIs did not result to be significantly associated with hyper-Hcy risk. Normal folate level was the only factor associated with the outcome, resulting protective from hyper-Hcy, either at univariate (OR = 0.22; CI 95% = 0.06-0.86; p = 0.029) and multivariable (OR = 0.24; CI 95% = 0.06-0.94; p = 0.04) logistic regression analysis. Folate predictive value of hyper-Hcy risk was driven by levels in the lowest quartiles of the study population (i.e. <10.9 nmol/l).


CONCLUSIONS
No significant correlations were observed between hyper-Hcy and length of exposure to antiretroviral therapy or PIs. Folate could be a confounding factor in the association between hyper-Hcy and PI exposure found by others. The potential value of folate supplementation, in those who are deficient and in those with hyper-Hcy, merits study.
Uccelli
Maria Cristina
MC
Institute for Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. uccellicristina@yahoo.it
Torti
Carlo
C
Lapadula
Giuseppe
G
Labate
Lorena
L
Cologni
Giuliana
G
Tirelli
Valeria
V
Moretti
Francesca
F
Costarelli
Silvia
S
Quiros-Roldan
Eugenia
E
Carosi
Giampiero
G
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D005492:Folic Acid / Q000097:blood*; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D013997:Time Factors
D019380:Anti-HIV Agents; D011480:Protease Inhibitors; D006710:Homocysteine; D005492:Folic Acid