Abstract
HIV and TB infections are both associated with elevated oxidative stress parameters. Anti-oxidant supplementation may offer beneficial effects in positively modulating oxidative stress parameters in HIV and HIV-TB infected patients. We investigated the effects of vitamin A and C supplementation on oxidative stress in HIV infected and HIV-TB co-infected subjects. 40 HIV/TB co-infected and 50 HIV mono-infected patients were divided into 2 equal groups. Participants provided demographic information and blood was collected to determine oxidative stress parameters before and after vitamin A (5000 IU) and C (2600 mg) supplementation for 1 month. There was a significantly (p < 0.05) higher level of Malondialdehyde (MDA) at baseline for HIV infected subjects compared with HIV-TB co-infected subjects. There was a significantly (p < 0.05) lower level of MDA and higher level of Catalase (CAT) in subjects administered supplementation compared to subjects without supplementation for the HIV infected group. There was a significantly lower level of Reduced Glutathione (GSH), Superoxide Dismutase (SOD) and higher level of MDA after one month of supplementation compared with baseline levels for HIV/TB co infected subjects. A similar result was also obtained for the HIV mono-infected groups which had a significantly lower level of SOD, MDA and CAT compared to the baseline. There was a significantly lower level of GSH and SOD, and higher level of MDA after supplementation compared with the baseline for HIV/TB co-infected subjects. Comparing the indices at baseline and post no-supplementation in HIV/TB co-infection showed no significant differences in the oxidative stress parameters. HIV/TB co-infection and HIV mono-infection seems to diminish the capacity of the anti-oxidant system to control oxidative stress, however exogenous anti-oxidant supplementation appears not to have beneficial roles in positively modulating the associated oxidative stress.
Highlights
Acquired Immune Deficiency Syndrome is a fatal illness caused by a retrovirus known as the human immunodeficiency virus (HIV) that breaks down the body’s immune system, infects CD4+ cells initially, progressively and leads to a chronic depletion of the immune system.[1,2] This syndrome is often associated with rare opportunistic infections which includes Mycobacterium tuberculosis, pneumonia and others.[3]
A dysfunction of anti-oxidant system have been observed in patients on anti-retroviral therapy, suggesting the roles of oxidative stress in antiretroviral toxicities, this is because Highly Active Antiretroviral Therapy (HAART) seems to elevate reactive oxidative species in circulation, by producing more oxidized species due to the reactions between ROS and cellular molecular components.[15,16]
Study site The study was conducted at the AIDS Prevention Initiative of Nigeria (APIN) Clinic, Lagos University Teaching Hospital, Lagos, Nigeria; which is one of the treatment centers and a research center for the HIV relief program in Nigeria
Summary
Acquired Immune Deficiency Syndrome is a fatal illness caused by a retrovirus known as the human immunodeficiency virus (HIV) that breaks down the body’s immune system, infects CD4+ cells initially, progressively and leads to a chronic depletion of the immune system.[1,2] This syndrome is often associated with rare opportunistic infections which includes Mycobacterium tuberculosis, pneumonia and others.[3]. Oxidative stress has been shown to be associated with TB infection through activation of phagocytes by mycobacteria which may further contribute to immunosuppression.[17,18] High level of oxidative stress has been reported in patients with tuberculosis as a result of tissue inflammation, poor nutrition and poor immunity and this stress becomes more severe in those with HIV-TB co-infection. A report has shown high levels of oxidative stress in HIV-TB co-infected patients.[19] Patients infected with HIV are in oxidative imbalance early in the disease; serum and tissue anti-oxidants levels are low and peroxidation products elevated.[20] High plasma levels of malondialdehyde (MDA), reduced plasma glutathione (GSH), and decreased superoxide dismutase (SOD) activities are normally found. This study was conducted to identify the modulatory roles of vitamin A and C supplementation on oxidative stress associated with HIV mono-infection and HIV-TB co-infection
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