Abstract
Flavonoids in cocoa and yerba mate have a beneficial role on inflammation and oxidative disorders. Their effect on HIV individuals has not been studied yet, despite the high cardiovascular risk of this population. This study investigated the role of cocoa and yerba mate consumption on oxidative and inflammatory biomarkers in HIV+ individuals. A cross-over, placebo-controlled, double-blind, randomized clinical trial was conducted in 92 individuals on antiretroviral therapy for at least six months and at viral suppression. Participants were randomized to receive either 65 g of chocolate or chocolate-placebo or 3 g of yerba mate or mate-placebo for 15 days each, alternating by a washout period of 15 days. At baseline, and at the end of each intervention regimen, data regarding anthropometry, inflammatory, oxidative and immunological parameters were collected. High-sensitivity C-reactive protein, fibrinogen, lipid profile, white blood cell profile and thiobarbituric acid reactive substances were assessed. There was a difference between mean concentrations of HDL-c (ANOVA; p ≤ 0.05) among the different regimens: dark chocolate, chocolate-placebo, yerba mate and mate-placebo. When a paired Student t-test was used for comparisons between mean HDL-c at baseline and after each regimen, the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.008).
Highlights
Cardiovascular complications are among the most common comorbidities in individuals withHIV/AIDS and are associated with a higher risk of mortality [1,2]
HDL particles are known to exert anti-inflammatory effects in the organism, while LDL-c, when oxidized, causes an increase in oxidative stress and the release of inflammatory markers [5,6]. This manifestation of dyslipidemia is common in individuals with HIV/AIDS, and these findings need to be monitored regularly, since it is well established that lipid profile changes occur during the atherosclerotic process [31,35,36]
The study complied with the requirements of cross-over trials [55]. This is the first clinical study in the international literature that evaluated the effect of chocolate and yerba mate consumption on the inflammatory and oxidative profile of individuals with HIV/AIDS
Summary
Cardiovascular complications are among the most common comorbidities in individuals withHIV/AIDS and are associated with a higher risk of mortality [1,2]. Different protein components of HIV and the chronic use of antiretroviral therapy (ART), in conjunction with metabolic alterations (e.g., lipid profile changes), cause an increase in oxidative stress and inflammatory markers, and these factors are likely to predispose to chronic diseases, such as cardiovascular disorders [3,4]. Reduced high-density lipoprotein (HDL-c) and increased low-density lipoprotein (LDL-c) levels are characteristics of individuals with HIV/AIDS. The increase in reactive oxygen species (ROS) induces the oxidation of LDL-c particles, predisposing to the formation of electronegative subfractions(LDL( ́))that possess cytotoxic and proinflammatory properties. These factors lead to the exacerbation of oxidative stress related to an increased inflammatory response and progression of the disease [5,6]
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