title: Short-term folinic acid supplementation improves vascular reactivity in HIV-infected individuals: a randomized trial.
abstract: OBJECTIVE
  HIV-infected individuals present a cluster of conditions that activate or injure the vascular endothelium. The administration of folates may exert beneficial effects on endothelial function in different populations at risk for cardiovascular disease. The aim of this study was to determine the effects of 4 wk of folinic acid supplementation on forearm vascular responses during reactive hyperemia in HIV-infected patients under highly active antiretroviral therapy.
  
  
  METHODS
  This was a prospective, randomized, double-blind, placebo-controlled trial to compare the effects of 4 wk of daily ingestion of 5 mg of folinic acid (n = 15) or placebo (n = 15). Participants had to have been on antiretroviral therapy (ART) for at least 6 mo before enrollment, with undetectable viral load, and CD4 cell count >200 cells/mm(3). Vascular function was evaluated with venous occlusion plethysmography at baseline and after 4 wk, for the determination of brachial artery reactive hyperemia, and after isosorbide dinitrate administration.
  
  
  RESULTS
  The groups were comparable. The mean age of patients was 45 y; there were eight women in each group. There was no difference regarding ART regimen. The supplementation of folinic acid produced a significant improvement in reactive hyperemia (from 14.9 to 21.2 mL•min•100 mL). The same was not observed in placebo group (from 15.3 to 14.6 mL•min•100 mL; group P, 0.017; time P < 0.001; interaction P < 0.001). Endothelium-independent responses remained unchanged.
  
  
  CONCLUSIONS
  Short-term folinic acid supplementation improved vascular reactivity in HIV-infected individuals enrolled in the studied. As folate supplementation is safe and relatively inexpensive, long-term clinical trials should be conducted.
authors: Exercise Pathophysiology Research Laboratory, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
authors: Shana S
authors: SS
authors: Grigoletti
authors: Grace
authors: G
authors: Guindani
authors: Ruy S
authors: RS
authors: Moraes
authors: Jorge P
authors: JP
authors: Ribeiro
authors: Eduardo
authors: E
authors: Sprinz
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001794:Blood Pressure; D001916:Brachial Artery / Q000187:drug effects / Q000378:metabolism; D001938:Brazil; D018791:CD4 Lymphocyte Count; D019587:Dietary Supplements; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000098:blood supply; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D014664:Vasodilation; D019562:Viral Load
chemical_list: D002955:Leucovorin