Predictive Factors of Hyperhomocysteinemia in HIV-Positive Patients

Bongiovanni, Marco; Casana, Maddalena; Pisacreta, M; Tordato, Federica; Cicconi, Paola; Russo, Umberto; Ranieri, Roberto; Monforte, Antonella d’Arminio; Bini, Teresa

doi:10.1097/qai.0b013e31802be3e8

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…Furthermore, the potential contribution of cART versus HIV disease severity could not be assessed given the design. In contrast, our results are similar to those of Bongiovanni and colleagues, who measured plasma HCy levels in 83 treatment naïve HIV-infected subjects, 161 on cART, and 54 healthy controls13. Although mean Hcy levels were higher in the subjects on cART compared to the other two groups in an unadjusted analysis, only older age and low serum folate concentration (and not patient group) were associated with hyperhomocysteinemia in a multivariate analysis.…”

Section: Discussionsupporting

confidence: 89%

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Plasma Homocysteine Is Not Associated With HIV Serostatus or Antiretroviral Therapy in Women

Raiszadeh

Hoover

Lee

et al. 2009

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background The effects of HIV serostatus and combination antiretroviral therapy (cART) on plasma homocysteine (Hcy) are uncertain. Methods Plasma Hcy was assayed in a cross-sectional study of 249 HIV-infected and 127 HIV-uninfected women at the Bronx Women’s Interagency HIV Study site. Results Mean plasma Hcy was 7.42 ± 2.68 in HIV-infected and 7.18 ± 2.66 µmol/L in HIV-uninfected women (P = 0.40). Hyperhomocysteinemia (defined as Hcy > 10 µmol/L) was seen in 16.9% and 13.4 % of HIV-infected and HIV-uninfected women, respectively (P=0.45). Among HIV-infected women, cART use was not associated with Hcy level. Compared to the lowest quartile, women with Hcy in the highest quartile had lower mean serum vitamin B12 and RBC folate levels. In multivariate analysis that did not include micronutrient levels, age, serum creatinine and lower CD4% were significantly associated with plasma Hcy level in HIV-infected women. Conclusions Plasma Hcy was not associated with HIV serostatus or use of cART in this cross-sectional study. Reduced availability of folate cofactors for Hcy remethylation in HIV-infected women with lower folate intake and decreased health status may influence Hcy levels.

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Section: Discussionsupporting

confidence: 89%

“…Two prior studies found that serum folate concentrations were independently associated with hyperhomocysteinemia in HIV-infected patients 13,14. Folate or vitamin B12 insufficiency due to poor intake or malabsorption could be a function of or marker of severity of HIV disease.…”

Section: Discussionmentioning

confidence: 98%

Plasma Homocysteine Is Not Associated With HIV Serostatus or Antiretroviral Therapy in Women

Raiszadeh

Hoover

Lee

et al. 2009

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Folate and homocysteine have an inverse relation in HIVinfected individuals. Several studies found an association of antiretroviral therapy or duration of therapy with hyperhomocysteinemia and low folate concentrations (35,36,41,42), whereas others detected no association (43)(44)(45). Additional research is needed to confirm the relation between folate and different types and combinations of antiretrovirals and to clarify the biological mechanisms.…”

Section: Discussionmentioning

confidence: 92%

Plasma Micronutrient Concentrations Are Altered by Antiretroviral Therapy and Lipid-Based Nutrient Supplements in Lactating HIV-Infected Malawian Women

Flax

Adair

Allen

et al. 2015

The Journal of Nutrition

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“…To date, few studies have evaluated HHcy in HIV‐positive individuals. The prevalence of HHcy in our study (28.3%) was similar to that reported by Uccelli et al [26] and Bongiovanni et al [27], but much higher than that reported by Bernasconi et al [28]. To our knowledge, this is the largest cohort study to explore Hcy levels and their relationship to CVR in HIV‐positive individuals.…”

Section: Discussionmentioning

confidence: 99%

Hyperhomocysteinaemia in HIV‐infected patients: determinants of variability and correlations with predictors of cardiovascular disease

et al. 2008

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ObjectiveWe evaluated hyperhomocysteinaemia (HHcy) in a cohort of HIV-infected patients in order to assess its relation to cardiovascular risk (CVR) and identify determinants of HHcy variability. MethodsCross-sectional observational study. HIV-infected patients on stable highly active antiretroviral therapy (ART) were evaluated for the presence of the metabolic syndrome, lipodystrophy and traditional CVR factors. Plasma homocysteine levels were measured using high-performance liquid chromatography. ResultsFive hundred and sixty-seven patients (38% female) with a median age of 44 years were included in the study. Homocysteine (Hcy) was significantly higher in patients with the metabolic syndrome and lipodystrophy. No significant association was found between Hcy levels and the use of ART. However, Hcy was associated with higher blood pressure, waist circumference and waist-to-hip ratio, total lean body mass, visceral adipose tissue (VAT), VAT/total adipose tissue, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, high-density lipoprotein cholesterol, apolipoprotein A1, B, and creatinine. All 10-year CVR assessment scores were significantly associated with Hcy. In a multivariate regression model, systolic blood pressure, vitamin supplementation and HOMA-IR were significantly and independently related to Hcy. ConclusionsHcy is elevated in HIV-infected patients and is significantly associated with increased CVR. Measurement of Hcy might be useful in identifying particularly high-risk populations at whom therapeutic interventions could be targeted.

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Predictive Factors of Hyperhomocysteinemia in HIV-Positive Patients

Cited by 12 publications

References 10 publications

Plasma Homocysteine Is Not Associated With HIV Serostatus or Antiretroviral Therapy in Women

Plasma Homocysteine Is Not Associated With HIV Serostatus or Antiretroviral Therapy in Women

Plasma Micronutrient Concentrations Are Altered by Antiretroviral Therapy and Lipid-Based Nutrient Supplements in Lactating HIV-Infected Malawian Women

Hyperhomocysteinaemia in HIV‐infected patients: determinants of variability and correlations with predictors of cardiovascular disease

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