Antiretroviral Therapy Initiation Alters the Redox System of Asymptomatic HIV‐Infected Individuals: A Longitudinal Study

Abstract

Background. The combination antiretroviral therapy (cART) increases the oxidative stress in HIV-infected people, which in turn favors the onset and aggravation of non-AIDS comorbidities, a common situation affecting these individuals. We aimed to evaluate the influence of cART initiation on oxidative stress parameters. This is a longitudinal study including 30 asymptomatic patients divided according to their CD4+ T cell count (G1: <500 cell/mL; G2: >500 cell/mL) before (M0) and after (M1) cART initiation. We analyzed total antioxidant capacity (TAC), fat-soluble vitamins, malondialdehyde, 8-isoprostane, and DNA damage. Results. Results showed a decrease in TAC, retinol, α-tocopherol, and some carotenoids, in addition to a significant increase in DNA damage at M1. These changes were more evident in G2 subjects. Moreover, there was a significant 8-isoprostane increase at M1 in individuals belonging to G1. Conclusion. The results indicate that cART interfered in the redox system, mainly by reducing the antioxidant defenses. In addition, patients who had CD4+ T counts higher than 500 cells/mm3 showed more susceptibility to genotoxicity, while patients with less CD4+ T counts displayed more damage triggered by lipoperoxidation. Considering the early beginning of cART, its chronic use, and its capacity to alter the redox status, further long-term studies on larger cohorts are needed to define the best time to initiate therapy and to investigate new strategies to delay the development of non-AIDS diseases.

Serum levels of antioxidants and its supplementation in people living with HIV: integrative review

“…The selected studies were conducted in the American and African continents, in different countries, namely: Brazil (3), the United States of America (2), Nigeria (1), and Cameroon (2). The eight studies were divided into prospective observational studies [18][19][20]23 and clinical trials with supplementation of antioxidants (vitamins A and C17 and glutathione22) or food sources of antioxidants (dark chocolate and yerba mate 21 and Spirulina 24 ). Table 1 presents the main findings of the selected articles and their limitations.…”

“…Table 1 presents the main findings of the selected articles and their limitations. Five studies included individuals up to 60 years of age [17][18][19][20][21] , two 22,23 included individuals up to 65 years of age, and one study 24 did not provide information on the age of the participants.…”

“…This review showed that although there is a theoretical basis to indicate supplementation of antioxidants in PLHIV, there is still no robust evidence for this recommendation, given the variability in the methodology of clinical trials. Observational studies have shown that the onset of ART 18 , prolonged use 20 , and smoking 23 negatively influenced the parameters of OS and that deficiency of antioxidants was associated with more significant damage to mitochondrial DNA 19 .…”

Redox imbalance is related to HIV and pregnancy

“…Oxidative stress and the inflammatory process play a crucial role in the progression of AIDS. The variation in the redox balance at different stages of infection is explained by viral effects and also by ART, considering that despite treatment, there is an intense generation of ROS with deregulation of endogenous antioxidant molecules [ 2 , 3 , 8 , 9 , 25 , 26 ]. Pregnancy is also a state of intense oxidative stress [ 27 ] which is regulated by various physiological mechanisms in order to maintain the balance between radical production and the antioxidant capacity that will allow the normal progression of gestation and fetal growth [ 28 ].…”

Differential of Antioxidant Ability, CD4+T Cells Count and Viral Load in HIV Infected Patients on cART in Yaounde, Cameroon

“…HIV induces the generation of ROS through the regulatory protein Tat and the envelope glycoprotein gp120 [12,13] and the oxidative stress induced, increases viral replication and a variety of biochemical and physiologic changes, and contributes to CD4+ T lymphocyte depletion by increasing their rate of apoptosis [10,14]. Increased production of ROS during HIV-1 infection has been reported in some studies involving ART, indicating an increase of oxidative stress in response to treatment [15][16][17][18] whereas others described it to be more pronounced in naïve patients [19,20]; but in Cameroun, a country located in Sub Saharan Africa, very little is known about, especially those who are heavily treated, and of our knowledge, no study stress markers. Therefore, we aimed to investigate some oxidative stress markers, the overall antioxidant ability using FRAP assay in HIV-1 infected patients and the effect of treatment on their variation, and then to find out their correlation to CD4+ T cells count and viral load, for the patients' better management.…”