Effect of highly active antiretroviral therapy on homocysteine plasma concentrations in HIV-1-infected patients.
OBJECTIVE
To analyze the effect of antiretroviral therapy on homocysteine levels in HIV-1-infected patients.


METHODS
Observational, prospective study of patients with AIDS.


METHODS
We included patients with HIV-1 infection naive for antiretroviral drugs. Before and after 6 months of treatment, we evaluated fasting and postoral methionine load plasma homocysteine, serum vitamins B6 and B12, and intraerythrocyte folate levels.


RESULTS
We studied 69 patients who began therapy for a 6-month period. Fasting and postoral methionine load plasma homocysteine levels increased significantly after 6 months of antiretroviral therapy with respect to basal values (P < 0.001). Fasting hyperhomocysteinemia was present in 7.3% of patients before treatment and in 89.9% after 6 months of therapy (P = 0.0001). Postoral methionine load hyperhomocysteinemia was found in 4.5% of subjects before therapy vs. 98.5% at the end of study period (P = 0.001). These results were not associated with folate or vitamins B6 or B12 levels.


CONCLUSIONS
In patients with HIV-1 infection, fasting and postoral methionine load plasma homocysteine levels increased after 6 months of antiretroviral treatment. Nutritional abnormalities were not responsible for hyperhomocysteinemia, suggesting that enzymatic disturbances in the metabolic pathways of homocysteine may occur.
Coria-Ramirez
Erika
E
Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, HGR Gabriel Mancera, Instituto Mexicano del Seguro Social, Mexico.
Cisneros
Leopoldo Nieto
LN
Treviño-Perez
Sandra
S
Ibarra-Gonzalez
Isabel
I
Casillas-Rodriguez
Jesus
J
Majluf-Cruz
Abraham
A
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D005492:Folic Acid / Q000032:analysis; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000139:chemically induced*; D008875:Middle Aged; D010949:Plasma / Q000737:chemistry; D011446:Prospective Studies; D014805:Vitamin B 12 / Q000097:blood; D025101:Vitamin B 6 / Q000097:blood
D019380:Anti-HIV Agents; D006710:Homocysteine; D025101:Vitamin B 6; D005492:Folic Acid; D014805:Vitamin B 12