ABSTRACT
BACKGROUND: HIV infection and opportunistic infections cause oxidative stress (OS), which is associated with tissue damage. Anti-retroviral therapy (ART) is used to treat HIV and decrease the risk of opportunistic infections, but it is unclear whether ART reduces OS. Association of ART with OS was investigated. METHODS: We stratified a convenience sample of frozen serum or plasma from HIV-infected, ART-naïve (n=21); HIV-infected, ART-treated (n=14); HIV and PTB co-infected, ART-naïve (n=21); HIV and PTB co-infected, ART-treated (n=25) patients. Controls (n=21) were HIV-negative adults without TB symptoms. Concentration of OS markers namely: transaminases (ALT and AST), gamma glutamyl transpeptidase (GGT), albumin, total protein, malondialdehyde (MDA), vitamin C, and total anti-oxidant status (TAS) were determined. RESULTS: AST (p<0.001), GGT (p<0.001), total protein (p=0.001) and MDA (p<0.001) were higher in HIV patients compared to controls. Vitamin C (P<0.0001) and albumin (p<0.01) were lower in HIV-patients relative to controls. ART was only associated with higher albumin (p=0.001), higher GGT (p=0.02) and lower vitamin C (p=0.009). HIV and PTB co-infection was only significantly associated with higher GGT (p=0.01) and AST (p=0.03). CONCLUSION: We identified severe OS among HIV-patients. ART was associated with both increased and reduced markers of OS hence suggesting that ART may not attenuate OS.
Subject(s)
Anti-Retroviral Agents/therapeutic use , Biomarkers/blood , Coinfection/epidemiology , HIV Infections/drug therapy , Oxidative Stress/drug effects , Tuberculosis/complications , AIDS-Related Opportunistic Infections/blood , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/microbiology , Adult , Antiretroviral Therapy, Highly Active/methods , Antitubercular Agents/therapeutic use , Female , HIV Infections/blood , HIV Infections/diagnosis , HIV Infections/epidemiology , HIV-1/drug effects , Humans , Inpatients , Male , Middle Aged , Mycobacterium tuberculosis/drug effects , Oxidative Stress/physiology , Tuberculosis/blood , Tuberculosis/drug therapy , Tuberculosis/microbiology , Uganda/epidemiologyABSTRACT
BACKGROUND: Vitamin A deficiency is a public health problem in most developing countries. The technological challenges associated with the measurement of serum retinol have limited the epidemiologic assessment of vitamin A deficiency. The combination of retinol-binding protein (RBP) enzyme immunoassay and dried blood spots offers a rapid, inexpensive, and reliable tool for the population-level assessment of vitamin A deficiency in resource-poor settings. OBJECTIVE: To report on the application of RBP enzyme immunoassay and dried blood spots to assess serum retinol concentrations as an indicator of vitamin A status in the Uganda Demographic and Health Survey 2006. METHODS: A total of 5,642 capillary blood spot samples were collected by fingerprick onto filter paper cards from women (15-49 years) and children (6-59 months) in a representative probability sample of 9,864 households between May and October 2006. The cards were dried, packed individually with desiccant, and kept at 4 degrees C in a portable refrigerator in the field and at -20 degrees C in the laboratory. Prior to analysis, the RBP enzyme immunoassay was optimized with the use of matched serum and dried blood spots. RESULTS: The correlation between RBP values determined by matching serum and dried blood spots was excellent (r = 0.79, p < .00001). The prevalence of vitamin A deficiency in women (RBP < 1.24 micromol/L) and children (RBP < 0.825 micromol/L) was 19.4% and 20.4%, respectively. CONCLUSIONS: The combination of RBP enzyme immunoassay and dried blood spots is a simple, reliable, and cost-effective tool for the estimation of vitamin A deficiency in population-level surveys in resource-poor settings.
