Relationship between hepatitis C virus (HCV) and insulin resistance, endothelial perturbation, and platelet activation in HIV-HCV-coinfected patients under highly active antiretroviral treatment.

Insulin resistance is associated with highly active antiretroviral therapy in HIV-infected patients, and the risk of developing insulin resistance is increased in hepatitis C virus (HCV)-infected patients. The aim of the present study was to determine whether hepatitis C virus infection constitutes an additional risk factor for insulin resistance or other prothrombotic conditions in HIV-HCV coinfected patients under highly active antiretroviral therapy. One hundred eighteen HIV-infected patients were studied: 50 who had no history of anti-HIV treatment and 68 who were receiving therapy with highly active antiretroviral treatment. The treatment-naive group consisted of 35 HCV-negative subjects and 15 HCV-positive ones. Within the treated group, 50 patients were HCV negative and 18 were HCV positive. For each patient, the lipid profile was determined and the following values measured: glucose, soluble P-selectin (as a marker of platelet activation), soluble thrombomodulin, von Willebrand factor and soluble vascular cell adhesion molecule-1 (as endothelial markers), and insulin resistance. No significant difference (p>0.05) for any variable was found among subjects with or without HCV coinfection in the treatment-naïve group. Among patients under highly active antiretroviral therapy, however, those with HCV coinfection showed higher values (p<0.05) for insulin resistance (homeostasis model assessment value: 2.65 vs. 1.79), glucose (93 vs. 86 mg/dl), endothelial markers (von Willebrand factor, 204 vs. 123%; soluble vascular cell adhesion molecule-1, 650 vs. 482 ng/ml), and platelet activation marker (soluble P-selectin, 78 vs. 51 ng/ml) in parallel with lower CD4+ cells counts (289 vs. 402 cells/mm3) and higher HIV-1 viral loads (305 vs. 50 copies/ml) compared to patients without HCV coinfection. Glucose, soluble P-selectin, and von Willebrand factor were independently related to HCV infection. The presence of HCV coinfection during HIV treatment was closely related to higher values of insulin resistance, to activated platelets, and to endothelial perturbation in parallel with lower CD4+ cell counts and higher HIV-1 viral loads compared to patients without HCV coinfection. On the basis of these results, it may be preferable to treat HCV infection prior to initiating treatment for HIV infection in HIV-HCV-coinfected patients.

Casimiroa edulis seed extracts show anticonvulsive properties in rats.

A single dose of 5, 10 and 100 mg/kg of Casimiroa edulis aqueous extract (AQ); 10, 100 and 1000 mg/kg of C. edulis ethanolic extract (E-OH); in addition, 10, 30 and 12 mg/kg of propyleneglycol (Pg), phenytoin (Phen) and phenobarbital (Phb) was orally given to adult male Wistar rat groups. Thereafter, all groups were assayed for protection against maximal electroshock (MES) and pentylenetetrazole (METsc) seizure inducing tests at hourly intervals throughout 8 h. For MES, a maximal protection of 70% at the 2nd and 4th h with 10 mg/kg AQ and 100 mg/kg E-OH doses, occurred. That of Phen, Phb and Pg was 80, 90 and 10% at the 8th, 6th and 2nd h, respectively. The averaged values of the MES unprotected rats under 10 and 100 mg/kg of AQ and E-OH extracts, showed that a shortened reflex duration as well as a delayed latency and uprising times occurred. On the other hand, just an enlarged latency and no protection against METsc device in AQ and EOH was observed. Phen and Phb maximal protection was 80 and 100% at the 4th and 6th hour against METsc. Thus, AQ is tenfold more potent anticonvulsive extract than E-OH against MES.