Some biochemical changes in hiv positive patients on highly active antiretroviral therapy

Thesis Abstract

Some biological changes are observed during human immuno deficiency virus (HIV) infection. Once CD4+ count decreases to 500 cells/mm3 highly active antiretroviral therapy (HAART) is initiated. This work, seeks to elucidate the effect of HAART on some of the biochemical changes caused by HIV infection. 63 subjects comprising, 20 apparently healthy control subjects and 43 HIV positive subjects ready to be placed on HAART (these subjects attended HIV clinic in Bishop Shanahan Hospital Nsukka) were recruited for the study. A known volume of blood, 10ml was collected from each subject through venepuncture prior to the initiation of HAART (basal sample) then 4 and 8 months into the administration of HAART. The activities and concentrations of the following biochemical parameters catalase, glutathione peroxidase, superoxide dismutase, glutathione reductase, glutathione, zinc, selenium, vitamin C, vitamin E, creatinine, urea, aspartate amino transferase (AST), alanine amino transferase (ALT), total protein and albumin, were determined. CD4+ count was also determined at each presentation. The results showed that CD4+ count increased significantly from baseline to 8 months into treatment (p < 0.05), catalase and superoxide dismutase activities deteriorated from baseline to 8 months into treatment (p < 0.05). Glutathione peroxide showed a slight drop at the 8th month (p < 0.05). Glutathione reductase, reduced glutathione, zinc, selenium and vitamin C increased significantly from baseline to 8 months into treatment. Vitamin E showed no significant change in concentration (p > 0.05). Urea increased from baseline to 4 months into treatment (p < 0.05), but decreased to baseline levels by the 8 month (p < 0.05). There was no appreciable change in the creatinine level over the period of treatment (p > 0.05). ALT and AST increased from baseline to 4 months into treatment, but decreased by the 8th month, (ALT p < 0.05) (AST p > 0.05). Total protein and albumin rincreased significantly from baseline to 8 months into treatment (p < 0.05). Even though the studied parameters improved because of treatment they were still significantly different from the observations made for the healthy control subjects (p < 0.05). There were significant positive correlations between the mean CD4+ count of the whole population (negative control and test subjects) and the mean concentrations and activities observed for catalase, GPX, SOD, GR, GSH, zinc, selenium, vitamin C, total protein and albumin (p < 0.05), while significant negative correlations were observed between CD4+ count and urea, creatinine, AST and ALT (p < 0.05). On the other hand the correlations observed for the both control subjects and when treated separately HIV positive patients were not significant (p > 0.05). Hence treatment with HAART amounted to a positive prognosis for HIV/AIDS infection, but the effect on catalase, GPX and SOD is a pointer towards the need to boost the antioxidant nutrient supply alongside the administration of the treatment for a better patient management.