Changes in antioxidant profile among HIV-infected individuals on generic highly active antiretroviral therapy in southern India.
OBJECTIVE
The role of oxidative stress in disease progression has been shown to be more complicated in HIV-infected individuals receiving highly active antiretroviral therapy (HAART) compared to those who remain treatment-naïve. This study examined the changes in the antioxidant profile of HIV-infected subjects who remained HAART-naïve due to a high CD4 cell count and HIV-negative controls, over a 12-month follow-up period at YRG CARE, a tertiary HIV referral centre in southern India.


METHODS
We prospectively studied 35 HIV-infected participants (18 on d4T+3TC+EFV (stavudine+lamivudine+efavirenz), eight on AZT+3TC+EFV (zidovudine+lamivudine+efavirenz), and nine who were antiretroviral therapy-naïve) and 20 HIV-negative controls. Antioxidant profile (total antioxidant status, glutathione reductase, glutathione peroxidase, uric acid, ceruloplasmin, zinc, and albumin), CD4 cell count, plasma viral load, dietary intake, and history of smoking and alcohol use were determined at baseline and at twelve months.


RESULTS
At 12 months, participants on HAART showed a significant increase in glutathione peroxidase (baseline: 1765 vs. 12 months: 2850U/l; p<0.001) and albumin (3.6 vs. 4.4g/dl; p<0.001), and a significant decrease in glutathione reductase (52.6 vs. 50.5U/l; p=0.054) and uric acid (5.4 vs. 4.8mg/dl; p=0.027) compared to baseline. Also HAART-naïve participants had a significant increase in albumin (baseline: 3.7 vs.12 months: 4.3g/dl; p=0.023) and a significant decrease in zinc levels (baseline: 79.0 vs.12 months: 74.5microg/dl; p=0.052) from baseline to 12 months. HIV-negative subjects had a significant increase in glutathione reductase at 12 months from baseline (baseline: 37 vs.12 months: 39U/l; p=0.002). No significant difference in total antioxidant status, ceruloplasmin, and zinc levels were observed in HAART-experienced subjects and negative controls over the 12-month follow-up period.


CONCLUSIONS
This study documents changes in antioxidants over a period of time in HAART-experienced subjects in a southern India setting.
Sundaram
Muthu
M
Infectious Diseases Laboratory, YRG Centre for AIDS Research and Education (YRG CARE), VHS Hospital Campus, Rajiv Gandhi Salai, Taramani, Chennai 600 113, India.
Saghayam
Suneeta
S
Priya
Bhaskar
B
Venkatesh
Kartik K
KK
Balakrishnan
Pachamuthu
P
Shankar
Esaki Muthu
EM
Murugavel
Kailapuri G
KG
Solomon
Suniti
S
Kumarasamy
Nagalingeswaran
N
D000328:Adult; D000418:Albumins / Q000187:drug effects / Q000378:metabolism; D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000975:Antioxidants / Q000378:metabolism; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D048588:Benzoxazines / Q000494:pharmacology / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D016568:Drugs, Generic / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005979:Glutathione Peroxidase / Q000187:drug effects / Q000378:metabolism; D005980:Glutathione Reductase / Q000187:drug effects / Q000378:metabolism; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D007194:India; D019259:Lamivudine / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects*; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018119:Stavudine / Q000494:pharmacology / Q000627:therapeutic use; D014527:Uric Acid / Q000378:metabolism; D055815:Young Adult; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use
D000418:Albumins; D000480:Alkynes; D019380:Anti-HIV Agents; D000975:Antioxidants; D048588:Benzoxazines; D003521:Cyclopropanes; D016568:Drugs, Generic; D018894:Reverse Transcriptase Inhibitors; D014527:Uric Acid; D019259:Lamivudine; D015215:Zidovudine; D018119:Stavudine; D005979:Glutathione Peroxidase; D005980:Glutathione Reductase; C098320:efavirenz