Change in Nutritional and Biochemical Status in People Living with HIV-1 on Antiretroviral Therapy

Abstract

Antiretroviral therapy (ART) improves the quality of life of people living with HIV-1 (PLHIV) and reduces the mortality rate, but some individuals may develop metabolic abnormalities. This study evaluated changes in the nutritional status and biochemistry of PLHIV on antiretroviral therapy in a cohort that had not previously received ART and to follow up these individuals for 24 months after starting treatment. The initial cohort consisted of 110 individuals and ended with 42 people, assessed by a physical examination. A biochemical assay was performed using the colorimetric enzyme reaction technique, the proviral load was detected by qPCR and the quantification of the CD4/CD8 T lymphocytes was conducted by flow cytometry. PLHIV had increased levels of total cholesterol, LDL, triglycerides, ALT, urea and creatinine after 24 months of ART use (p < 0.05). In the assessment of the nutritional status, PLHIV had increased measures of Triciptal Skinfold, body mass index and arm circumference after the use of ART (p < 0.05). The viral load levels decreased and the CD4 levels increased after 24 months of ART use (p < 0.05). The change in the nutritional status in PLHIV on antiretroviral therapy seems to be a slow process, occurring in the long term, therefore, there is the need for a constant evaluation of these people to identify patients who need a nutritional intervention.

The Expression Levels of TREX1 and IFN-α Are Associated with Immune Reconstitution in HIV-1-Infected Individuals

“…Given that ANA were present in individuals after ART, who had higher IFN-α levels, these individuals may have experienced a more pronounced recovery of immune competence, which proves to be independent of the type of therapeutic regimen used. Other studies have described the association of ART use with the recovery of immune competence and the development of ANA [ 3 , 6 ]. Screening for ANA in individuals with HIV-1 infection who are receiving ART is important for identifying who could be at risk for developing possible autoimmune manifestations [ 6 ].…”

“…Despite all the advances in the control of HIV-1 infection, the virus remains a major public health problem worldwide, with an estimated 1.3 million new infections each year [ 1 ]. Because there is still no treatment available to eradicate the infection, the main control measure is antiretroviral therapy (ART), which promotes a reduction in viral load to undetectable levels, allowing the restoration of the individual’s immune response [ 2 , 3 ]. Unfortunately, ART may contribute to the development of metabolic changes and autoimmune reactions [ 3 , 4 , 5 , 6 ].…”

“…Because there is still no treatment available to eradicate the infection, the main control measure is antiretroviral therapy (ART), which promotes a reduction in viral load to undetectable levels, allowing the restoration of the individual's immune response [2,3]. Unfortunately, ART may contribute to the development of metabolic changes and autoimmune reactions [3][4][5][6].…”

TREX1 531C/T Polymorphism and Autoantibodies Associated with the Immune Status of HIV-1-Infected Individuals

“…It is unquestionable that ART promotes improvements in the survival and life expectancy of individuals with HIV; however, the need for treatment for an indefinite period may result in the development of complications for some individuals living with the virus [24], including adverse effects, metabolic changes and autoimmune manifestations [3,4,6,7,25].…”

“…The introduction of antiretroviral therapy (ART) promoted a significant reduction in the morbidity and mortality rate caused by HIV-1 and has contributed to changing the scenario of the infection, which is now considered a chronic condition [2]. However, although ART has had a significant impact on infection control, its use needs to be monitored to assess possible intercurrences, including metabolic changes [3,4]. Prolonged use of ART has been associated with the development of autoimmune conditions, as ART, by promoting an improvement in the immune status, can induce different autoimmune reactions [5][6][7].…”