Vitamin E concentrations in adults with HIV/AIDS on highly active antiretroviral therapy.

Daniella J Itinoseki Itinoseki Kaio,Sigrid Sousa Santos,Patricia Helen C Rondó,José Maria P Souza,Liania Alves Luzia,Aline Vale Firmino

doi:10.3390/nu6093641

Daniella J Itinoseki Itinoseki Kaio, Sigrid Sousa Santos + Show 4 more

Open Access

https://doi.org/10.3390/nu6093641

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Abstract

HIV/AIDS patients are probably more predisposed to vitamin E deficiency, considering that they are more exposed to oxidative stress. Additionally, there are an extensive number of drugs in the highly active antiretroviral therapy (HAART) regimens that may interfere with vitamin E concentrations. The objective of this study was to compare serum concentrations of alpha-tocopherol in 182 HIV/AIDS patients receiving different HAART regimens. The patients were divided into three groups according to regimen: nucleoside analog reverse-transcriptase inhibitors (NRTIs) + non-nucleoside analog reverse-transcriptase inhibitors (NNRTIs); NRTIs + protease inhibitors + ritonavir; NRTIs + other classes. Alpha-tocopherol was assessed by high-performance liquid chromatography. Multiple linear regression analysis was used to evaluate the effects of HAART regimen, time of use, and compliance with the regimen on alpha-tocopherol concentrations. Alpha-tocopherol concentrations were on average 4.12 μmol/L lower for the NRTIs + other classes regimen when compared to the NRTIs + NNRTIs regimen (p = 0.037). A positive association (p < 0.001) was observed between alpha-tocopherol and cholesterol concentrations, a finding due, in part, to the relationship between liposoluble vitamins and lipid profile. This study demonstrated differences in alpha-tocopherol concentrations between patients using different HAART regimens, especially regimens involving the use of new drugs. Long-term prospective cohort studies are needed to monitor vitamin E status in HIV/AIDS patients since the beginning of treatment.

Highlights

Acquired immunodeficiency syndrome (AIDS) is characterized by progressive depletion and dysfunction of CD4 T cells, associated with the development of opportunistic infections and neoplasms
The introduction of highly active antiretroviral therapy (HAART) has significantly increased the life expectancy of patients infected with HIV
There are an extensive number of drugs in the HAART regimens [2] that may interfere with vitamin E concentrations in HIV/AIDS patients

Summary

Introduction

Acquired immunodeficiency syndrome (AIDS) is characterized by progressive depletion and dysfunction of CD4 T cells, associated with the development of opportunistic infections and neoplasms. Several mechanisms are involved in this process, including chronic immune activation that disrupts T cell homeostasis and induces oxidative stress, with depletion of plasma antioxidant concentrations [1,2]. Antioxidants are known to play a vital role in the immune system, reducing oxidative stress induced by the excessive production of reactive oxygen species [4]. Oxidative stress plays a critical role in the stimulation of HIV replication and in the development of immunodeficiency [1]. The introduction of highly active antiretroviral therapy (HAART) has significantly increased the life expectancy of patients infected with HIV.

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