Influence of folate serum concentration on plasma homocysteine levels in HIV-positive patients exposed to protease inhibitors undergoing HAART.
ABSTRACT Homocysteinemia (Hcy) increase and risk factors in HIV-positive patients are not clear yet.
HIV-positive patients on stable highly active antiretroviral therapy (HAART) regimens for at least 6 months were enrolled in this cross-sectional study. Among other factors, vitamin B12, folate and length of exposure to protease inhibitors (PIs) were evaluated for their possible correlation with hyper-Hcy (>13 micromol/l in females; >15 micromol/l in males) by logistic regression analysis.
Ninety-eight HIV-positive patients were recruited. Twenty-eight (28.6%) had hyper-Hcy. Length of exposure to antiretroviral therapy and PIs did not result to be significantly associated with hyper-Hcy risk. Normal folate level was the only factor associated with the outcome, resulting protective from hyper-Hcy, either at univariate (OR = 0.22; CI 95% = 0.06-0.86; p = 0.029) and multivariable (OR = 0.24; CI 95% = 0.06-0.94; p = 0.04) logistic regression analysis. Folate predictive value of hyper-Hcy risk was driven by levels in the lowest quartiles of the study population (i.e. <10.9 nmol/l).
No significant correlations were observed between hyper-Hcy and length of exposure to antiretroviral therapy or PIs. Folate could be a confounding factor in the association between hyper-Hcy and PI exposure found by others. The potential value of folate supplementation, in those who are deficient and in those with hyper-Hcy, merits study.
Article: Plasma homocysteine is not associated with HIV serostatus or antiretroviral therapy in women.[show abstract] [hide abstract]
ABSTRACT: The effects of HIV serostatus and combination antiretroviral therapy (cART) on plasma homocysteine (HCY) are uncertain. Plasma HCY was assayed in a cross-sectional study of 249 HIV-infected and 127 HIV-uninfected women at the Bronx Women's Interagency HIV Study site. Mean plasma HCY was 7.42 +/- 2.68 in HIV-infected women and 7.18 +/- 2.66 mumol/L in HIV-uninfected women (P = 0.40). Hyperhomocysteinemia (defined as HCY >10 mumol/L) was seen in 16.9% and 13.4% of HIV-infected and HIV-uninfected women, respectively (P = 0.45). Among HIV-infected women, cART use was not associated with HCY level. Compared with the lowest quartile, women with HCY in the highest quartile had lower mean serum vitamin B12 and RBC folate levels. In multivariate analysis that did not include micronutrient levels, age, serum creatinine, and lower CD4% were significantly associated with plasma HCY level in HIV-infected women. Plasma HCY was not associated with HIV serostatus or use of cART in this cross-sectional study. Reduced availability of folate cofactors for HCY remethylation in HIV-infected women with lower folate intake and decreased health status may influence HCY levels.JAIDS Journal of Acquired Immune Deficiency Syndromes 04/2009; 51(2):175-8. · 4.43 Impact Factor