ABSTRACT
A survey of one hundred and twenty HIV patients was carried out to evaluate a possible cause of acidosis in HIV patients using biochemical parameters such as Uric acid, Lactate dehydrogenase, Phosphate and Bicarbonate .The patients were drawn from Aba in Abia State. Fifty HIV positive and fifty HIV patients on antiretroviral drugs were tested respectively comprising of 30 females and 20 males. Twenty HIV negative subjects made of 10 females and 10 males served as control. Subjects were of age 20 -35 yrs, HIV patients were on antiretroviral drugs (triviro-LNS-Lamivudine, Nevirapine and Starvudine) 1-2 pills daily depending on the CD4 count. Moreso, have been on the drug for the duration of 2- 3 years. All the investigations were done with serum. The phosphate and uric acid was assayed using fortress diagnostic kit based on calorimetric assay, so also Lactate dehydrogenase. Bicarbonate was determined based on titrimetric method. The results of the study revealed that there was a significant increase in the serum levels of Phosphate and Uric Acid in HIV positive subjects not on drugs (phosphate level Control (mg/dL). 3.70 ± 1.54 vs 10.00 ± 4.00, uric acid level control (mg/dL) 4.61± 2.36 vs 7.60 ± 3.60 compared to HIV negative subjects and HIV infected subjects on Antiretroviral drugs. Inaddition the Bicarbonate level was significantly reduced in HIV positive subjects compared to the other two groups as well (control (mmol/L) 23.00 ± 6.19 vs 7.16 ± 3.50 ( P<0.05) .The activity of lactate dehydrogenase was very pronounced in HIV positive patients on antiretroviral drug compared to the other groups( P<0.05). Similarly, a significant increase in the serum level of Phosphate was obtained for HIV positive subjects on drugs compared to HIV negative subjects (control (mg/dL). 3.70 ± 1.54 vs 4.78 ± 1.80 P<0.05).The result indicated equally that HIV positive subjects on drugs exhibited slight decrease in the levels of Uric Acid and Bicarbonate compared to HIV negative subjects (P<0.05). This study is therefore supporting and encouraging HIV infected patients to take antiretroviral drugs to reduce the associated metabolic abnormalities.
ABSTRACT
Antiretroviral therapy has been associated with the development of metabolic abnormalities, including dislipemia, insulin resistance, and hyperlactatemia. Mitochondrial damage secondary to the use of nucleoside analogue reverse transcriptase inhibitors (NRTIs) has been related to some of these complications; although the role of different NRTIs in their development is not well established. It was the aim of this study to assess the incidence of oxidative stress and dislipemia in HIV-infected patients who began highly active antiretroviral therapy (HAART). HIV patients were on antiretroviral drugs (triviro-LNS-Lamivudine, Nevirapine and Starvudine) 1-2 pills daily depending on the CD4 count. Moreso, have been on the drug for the duration of 2- 3 years .Biochemical parameters such as Ascorbic acid (Vit C), Cholesterol and Triglyceride were monitored. Seventy five (75) patients were used in this study comprising, 50 HIV positive individuals taking relevant antiretroviral therapy at least for three months. Thirteen HIV positive persons that have just received their sero status from voluntary counseling and testing center (VCT) and are yet to start drug and 12 apparent healthy HIV seronegative individuals served as control. The blood collected from the patients was centrifuged and serum used for the determination of cholesterol, triglyceride. Though serum for vitamin C determination was deproteinized and 2, 4- dinitrophenylhydrazine used for its determination. Results obtained were subjected to statistical analysis using student’s test. Reduced concentrations of anti-oxidant vitamin C was found to be significantly decreased in HIV patients not on drugs when compared to control group, but level of triglyceride was drastically increased in HIV patients on drugs compared to HIV infected patients not on drugs(P<0.05). In addition, the level of cholesterol was increased in the body of people with HIV not on drugs (178.38 mg/dl) when compared to the HIV positive patients on drugs (163.28 mg/dl) and control subjects (169.67 mg/dl). This was statistically significant ( P<0.05). The study has shown that in HIV patient’s free radical activity is relatively high hence the low level of vitamin C obtained in this study. Though, this was more pronounced in HIV patients on drugs. Furthermore hyperlipidemia (increased triglyceride level) was equally observed as a result of dual effect of HIV infection and antiretroviral drugs in HIV patients on antiretroviral drugs. Change in oxidative status was also associated with alteration in lipid profile. Incidentally lipid profiles are now mostly affected by use of antiretroviral therapy. The study has revealed that lipid profile parameters are slightly altered in HIV individuals taking antiretroviral drugs. Even though slight, this alteration may cause cardiovascular complication with time and need to be monitored regularly.