HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) AND ANTIOXIDANT STATUS OF HIV – 1 INFECTED PATIENTS ATTENDING LAUTECH TEACHING HOSPITAL, OSOGBO, NIGERIA

Abstract

This study assessed the effect of highly active antiretroviral therapy (HAART) on lipid peroxidation and some antioxidants such as vitamin C, glutathione peroxidase, catalase and total antioxidant levels in HIV- 1 infected patients attending LAUTECH Teaching Hospital, Osogbo, Nigeria. A total of 100 subjects within the ages of 18 – 45 years were used for the study. Seventy of the subjects were patients who were screened and confirmed to be infected with Human Immunodeficiency Virus (HIV) attending the HIV Clinic located at Ladoke Akintola University Teaching Hospital, Osogbo. These infected HIV patients were divided into two groups; the first group consist of 35 HIV infected patients that were on Highly Active Antiretroviral Therapy (HAART) and were termed subjects (ON DRUG), the second group consisted of 35 HIV infected patients that were not on Highly Active Antiretroviral Therapy (HAART) and were termed subjects (NOT ON DRUGS). The remaining 30 subjects, who served as controls were carefully selected, screened and showed no serological evidence to be infected with HIV and results of other clinical analysis (blood glucose, full blood count, AST and ALT) were within normal ranges which ascertained that they were in stable health condition. MDA levels (lipid peroxidation levels) was significantly higher in HIV - 1 patients that are on drugs (10.39±9.46nmol/ml) compared to HIV - 1 patients that are not on drugs (5.69±4.47nmol/ml) and individuals that are in the control group (3.95±4.10nmol/ml), P <0.05. Total antioxidant status was significantly lower in HIV - 1 patients that are on drugs (on HAART) (0.66±0.12μmol/L) when compared with HIV - 1 patients that are not on drug (not on HAART) (0.86±0.30μmol/L) and individuals that are in the control group (1.06±0.32μmol/L), P < 0.05. On the other hand, vitamin C levels was highest in the control group (1.63±1.65mg/100g) compared to HIV positive patients that are on drugs (on HAART) (1.44±1.63mg/100g) and HIV positive patients that are not on drugs (not on HAART) (0.99±0.54mg/100g), the P-value was not significant. Glutathione peroxidase levels was also found to be highest in the control group (6599.34±827.32U/I) compared to HIV - 1 positive patients that were on drugs (on HAART) (3854.89±945.95U/I) and HIV - 1 positive patients that are not on drugs (not on HAART) (3249.97±1066.22 U/1), P < 0.05. The same observations was seen in the level of catalase activity, the mean value was highest in the control group (43.43±4.31 U/I) compared to HIV - 1 positive patients that are on drugs (on HAART) (31.35±4.53 U/I) and HIV - 1 positive patients that are not on drugs (not on HAART) (20.55±7.45 U/I), P < 0.05. In comparing the levels of malonydialdehyde, total antioxidant status, vitamin C, glutathione peroxidase and catalase levels in ten (10) randomly selected HIV infected patients that are on drugs (on HAART)and HIV infected patients that are not of drugs (not on HAART) , only one patient (Subject 8) out of the randomly selected ten HIV infected patients that are on drugs (Table 4) had a low malonydialdehyde level and moderate levels of total antioxidant capacity, vitamin C, glutathione peroxidase and catalase. This observation may be as a result of proper management of the virus which consists of early detection of HIV infection in the individual, maintaining a good health and nutritional status and the use of HAART adequately by that individual. Also, the results showed that six patients (Subject 4, 10, 14, 16, 18 and 20)out of the randomly selected ten HIV infected patients that are not on drugs had a lower level of malonydialdehyde and moderate levels of total antioxidant status, vitamin C, glutathione peroxidase and catalase. This observation proposes that HAART which is the therapy of choice in managing people infected with HIV has encouraged increase in lipid peroxidation and decrease in total antioxidant status in HIV infected patients than the HIV itself and ultimately potentiate oxidative stress in HIV patients under HAART treatment. The findings in this study suggest that for proper therapeutic management of HIV infected patients, antioxidant supplements such as vitamin C should be taken during the regime therapy and more research needs to be centered on nutritional/antioxidant supplementation in ameliorating HIV surge in-vivo.