Oxidative Stress and Mitochondrial Dysfunction in Human Immunodeficiency Virus Patients on Highly Active Antiretroviral Therapy

Description

– Oxidative Stress and Mitochondrial Dysfunction in Human Immunodeficiency Virus Patients on Highly Active Antiretroviral Therapy –

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Abstract

This study was aimed at evaluating oxidative stress and mitochondrial dysfunction in HIV patients on a combination of emtricitabine, tenofovir and efavirenz (ATRIPLA),

commonly used for treating these patients attending the HIV clinic of Enugu State University Teaching (ESUT) Hospital, Parklane, Enugu, Nigeria following short and long-term therapy.

Ninety six (96) subjects (divided into four groups) aged between 18 and 60 years were recruited for the study from the HIV clinic and the laboratory of the hospital.

Ethical clearance was obtained from the Ethical Committee of the same hospital. Group 1 consisted of twenty four (24) apparently healthy HIV sero-negative age–matched individuals (No HIV or control group) who work in different laboratories of the hospital.

Group 2 consisted of 24 sero-positive patients who had not started any form of treatment (treatment naive group), while group 3 was made up of twenty four (24) subjects on a short-term course of highly active antiretroviral therapy (HAART) (for less than one year).

Group 4 was made up of twenty four (24) subjects who were on HAART for more than one year, representing those on long-term therapy. Ten mililiters (10 ml) of blood sample was collected from each patient from the antecubital-vein without venous stasis into EDTA and plain bottles.

Serum was processed from the retracted whole blood and stored in duplicates in cryobottles at -20⁰C for biochemical analyses while the anticoagulated blood samples were further processed for CD4⁺ cell count and DNA extraction for genomic studies.

Introduction

1.1 Background of the Study

Human Immunodeficiency Virus (HIV) is the cause of the fatal condition called acquired immunodeficiency syndrome (AIDS).

AIDS was first recognized in the United States in 1980- 1981 when homosexual men were found to have unusual infections and tumours suggesting an underlying deficiency in their cell-mediated immunity (Maartens et al., 2014).

Evidence exists  to show that HIV has been present in humans for 15-20 years before then but the exact origin of the virus is not yet known (CDC, 2013).

Over the years, relative decline in morbidity and mortality of human immunodeficiency virus (HIV) infection in some countries has been observed due to the use of a potent combined therapy known as highly active antiretroviral therapies (HAART) (Maartens et al., 2014).

It has led to a decrease in viral load (a measure of the amount of HIV virus in the blood), quantitative and qualitative improvement of immune functions in patients, especially CD4⁺ T- lymphocytes count, resulting in a decrease of infectious complications and a global clinical improvement (Klatt and Silvestri, 2012).

In spite of the positive effects of HAART on the immune system and on the metabolic alterations during HIV infections, it has been reported that the commonly used drugs zidovudine (AZT), didanosine (ddI) and stavudine (d₄T) are toxic to hepatocytes and other tissues (Heil et al., 2010).

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