Acidosis in HIV patients on antiretroviral drugs.

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.

Antioxidant status and lipid profile in patients infected with human immune deficiency virus.

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.

Fasting insulin resistance indices and metabolic syndrome in diabetes and HIV infected subjects.

Diabetes Mellitus and HIV remain two major clinical conditions of public health importance especially in developing countries.HIV impairs normal immune response against malignant infections and destroy many organs impairing their functions including the pancrease. Ordinarily, the pancrease performs exocrine functions thus producing insulin from the beta cells of the islets of langerhan aiding in nutrient metabolism.The beta cells of islet can be destroyed by the T-lymphocytes resulting to clinical diabetes characterized by hyperglycemia Diabetes and HIV have been associated with metabolic dearrangement particularly lipodystrophy.It was in this line that we designed a study to monitor fasting insulin resistance indices and metabolic syndrome in120 subjects of age 30-55 years comprises of 50 HIV –Infected,50 Type 2 Diabetes and twenty apparently healthy subjects who served as control attending Nnamdi Azikiwe University Teaching Hospital Nnewi(NAUTH).The blood samples collected from the subjects were used for evalution of lipid profile Tryceride(TG) ,low density lipoprotein-cholesterol(LDL-C) and high density lipoprotein – cholesterol (HDL-C), Fasting blood sugar was measured using routine standard method while fasting insulin was done using indirect ELISA method .The insulin resistance indices were also evaluated. Data were analyzed for the statistical significance using one way ANOVA. The fasting insulin, fasting blood sugar, triglyceride and LDL-C were remarkably higher inType 2 Diabetic subjects compared to control P <0.01. Equally observed in the study was that the fasting insulin, fasting blood sugar and triglyceride were higher in HIV subjects compared to control subjects P <0.01.Though, the HDL-C was quite reduced in HIV –Infected subjects P <0.01. The finding of this study has revealed further lipid and carbohydrate distortion in both diabetic and HIV subjects which might place individuals to high risk of atherosclerosis due to reduced HDL-C if not checked.

Glucose and amylase activity in HIV and diabetic patients.

Diabetes Mellitus which develops as a result of insufficient insulin level in the body or insulin resistance to glucose, ultimately progresses to various complications like retinopathy, nephropathy, angiopathy and neuropathy. Abnormalities in the levels of glucose and amylase have always being linked to pancreatic diseases. We decided to venture into other possible disease conditions which might affect the two biochemical parameters (Glucose and amylase activity). We therefore looked at the effect of Diabetes and HIV on blood amylase activity and glucose concentration by assessing two hundred and twenty subjects who were randomly selected. Fifty patients were used for each group of diabetic not on drugs, diabetic on drugs, HIV patients not on drugs and HIV on drugs. Twenty healthy individuals served as control. The age of the subjects used was of 50±15 years all within Aba Metropolitan. .Five ml of blood was collected for the analysis of Glucose and amylase activity using standard biochemical methods. Data were analyzed for the statistical significance using one way ANOVA .In our study, we found that the concentration of glucose declined significantly in HIV patients not on drugs but the activity of amylase was remarkable increased in the same patients compared to control <0.05. Apparently, the activity of amylase was highest in diabetic individuals on drug compared to other groups studied. In conclusion serum amylase activity was remarkably elevated in diabetic patients and so estimation of serum amylase may possibly aid in the diagnosis of diabetes mellitus. Again from the result, there is need for both the diabetic and HIV patients to regularly check their blood sugar to prevent either hyperglycemia or hypoglycemia.