title: Influence of folate serum concentration on plasma homocysteine levels in HIV-positive patients exposed to protease inhibitors undergoing HAART.
abstract: 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.
authors.affiliation: Institute for Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. uccellicristina@yahoo.it
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Uccelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Torti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lapadula
authors.forename: Lorena
authors.initials: L
authors.lastname: Labate
authors.forename: Giuliana
authors.initials: G
authors.lastname: Cologni
authors.forename: Valeria
authors.initials: V
authors.lastname: Tirelli
authors.forename: Francesca
authors.initials: F
authors.lastname: Moretti
authors.forename: Silvia
authors.initials: S
authors.lastname: Costarelli
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
authors.forename: Giampiero
authors.initials: G
authors.lastname: Carosi
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents; D011480:Protease Inhibitors; D006710:Homocysteine; D005492:Folic Acid