SERUM MINERALS, LIPIDS AND LIVER ENZYMES IN HIV POSITIVE SUBJECTS RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)
ABSTRACT
The introduction of highly active antiretroviral therapy (HAART) has significantly improved life expectancy among HIV positive individuals. However the impact of this treatment on individual micronutrients, other biochemical parameters and cardiovascular risk has not been well elucidated in this environment.
This study evaluated cardiovascular risk factors, selenium, zinc, magnesium, lipid profile, fasting blood sugar, haemoglobin, CD4 count and transaminases among human immunodeficiency virus (HIV) afflicted Nigerian subjects on HAART.
Subjects are HIV afflicted adult patients who presented consecutively at Imo State University Teaching Hospital Orlu, who are HAART naïve and agreed to written consent. A total of 99 volunteers comprising 51 patients and 48 HIV sero-negative adults as control participated. Their body weight, height, blood pressure, arterial pulse rate were measured, 10 ml of fasting venous blood samples were also taken before commencing HAART and at 6 months on HAART. Samples were analyzed for lipid profile, blood sugar, magnesium, zinc, selenium, haemoglobin and CD4.
Serum magnesium, zinc and selenium were significantly lower in HIV patients before HAART (p < 0.05) compared with control. However, serum levels of these minerals significantly increased after HAART compared to pre-HAART values.
Serum aspartate aminotransferase (AST) concentration was significantly higher after HAART compared with control.
Serum triglyceride (TG) significantly increased following HAART compared to control while high density lipoprotein (HDL) increased compared to pre-HAART values (p<0.05). There was no significant change in total cholesterol before or after HAART compared to control.
CD4 count increased significantly in HIV patients while on HAART compared to values before HAART. However these values were lower than control value. Haemoglobin (Hb) significantly increased in HIV patients while on HAART when compared to these patients before HAART. Blood sugar levels were similar in all groups.
In conclusion, HAART was beneficial to the patients as it enhanced CD4 count, haemoglobin, and HDL but it increased serum triglyceride. HAART also improved low magnesium, zinc and selenium observed in HIV. This study suggests that the non protease inhibitor-based HAART may however predispose HIV patients to cardiovascular risk and that supplementation of these minerals may not be necessary in HAART.