Vitamin E Concentrations in Adults with HIV/AIDS on Highly Active Antiretroviral Therapy

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.

Antiretroviral Therapy Initiation Alters the Redox System of Asymptomatic HIV‐Infected Individuals: A Longitudinal Study

“…Another study by Kaio et al [8] compared α -tocopherol levels with antiretroviral classes and showed a decrease of this vitamin in nearly 20% of PLWHA [8]. Conversely in our study approximately 60% and 90% of the PLWHA showed α -tocopherol deficiency before and after cART introduction, respectively (data not shown).…”

“…After cART we observed a reduction in lutein ( p = 0.018) and lycopene levels ( p = 0.019) only in G2 group and in β -carotene ( p < 0.010) and α -tocopherol ( p < 0.050) in both G1 and G2 (Table 2). We also categorized the results of vitamins considering reference values previously established by Kaio et al [8] (<1.0 for β -carotene, <0.7  μ mol/L for retinol and <16.0  μ mol/L for α -tocopherol). The percentages of individuals with values below the ideal, prior to therapeutic initiation, were 93%, 17%, and 60% for β -carotene, retinol, and α -tocopherol, respectively.…”

“…In an attempt to justify the difference between these results, it is necessary to consider some aspects. In the cross-sectional study by Kaio et al [8], at the time of enrollment patients have already been using cART for an extended period, for nearly 10 years, and they had received more than one therapeutic scheme, including therapeutic rescue. On the other hand, in our longitudinal study treatment duration was only eight months on average, and most patients were receiving the first scheme composed of NNRTI which could reduce α -tocopherol levels.…”

“…In addition, a recent study with these markers has shown that oxidative stress was a predictor of all-cause mortality in HIV-infected patients, and, for F2-isoprostane, this association is independent of HIV-related factors and subclinical inflammation [16]. Further, HIV-individuals under cART have less total antioxidant capacity (TAC) [17] and a lower vitamin profile [8, 18] as compared to patients naïve to treatment. Thus not only the pathogenesis of HIV but also therapy may influence the increase in prooxidants and the decrease in antioxidants in PLWHA, leading to consequent damage to important biomolecules as lipids, protein, and nucleic acids [9, 19, 20].…”

Efeito dos compostos fenólicos do cacau e chá mate no perfil inflamatório de indivíduos com HIV/aids em terapia antirretroviral

“…P = 0,01 p = 0,02 p = 0,02 p = 0,01 p = 0,01 P = 0,01 p = 0,01 p = 0,03 p = 0,05 p = 0,01 p = 0,01 p = 0,01 p = 0,01 POTULAR et al, 2006;LEHNERT et al, 2014). O estado nutricional dos indivíduos da amostra é semelhante a outros estudos (FLORINDO et al, 2007;KAIO, 2013). A melhoria das condições de saúde de PVHIV/aids, em decorrência da TARV, reflete também no maior número de indivíduos eutróficos.…”