Impacts of highly active antiretroviral therapy (HAART) on metabolic status of patients with AIDS: What happens from the initiation of AIDS to the initiation of treatment?

Abstract

Background: Our study aimed to determine if alteration of metabolic parameters is associated with the severity of human immunodeficiency virus (HIV) infection, progress to acquired immunodeficiency syndrome (AIDS), or with the type of antiretroviral treatment (ART).Materials and Methods: In a cross-sectional study among 114 HIV infected patients, we measured hematological and biochemical parameters to assess metabolic alterations according to the disease process and anti-retroviral treatment. Results: Of 114 HIV-positive patients, there were 82 AIDS patients receiving ART and 32 HIV patients without treatment. Alkaline phosphatase and parathyroid hormone (PTH) had lower serum levels in HIV patients with CD4+ cell count ≤250 (P < 0.01). CD4+ cell count was higher in patients receiving Protease Inhibitors (PI) and Nucleoside Reverse Transcriptase Inhibitors (NRTI) regimen compared with those treated with Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) and NRTI or NRTI alone. Calcium (Ca) serum level was lower in patients with only NRTI regimen while Phosphorus (P) serum level was higher in patients on NNRTI and NRTI (P < 0.05). Conclusion: CD4+ cell count ≤250 cells/μl in HIV-positive patients is associated with decreased level of triglyceride and PTH. Moreover, patients receiving NRTI
regimen alone have lower Ca level while this regimen in combination with NNRTI or PI has a positive correlation with P serum level.

Key words: AIDS, Biochemistry, cART, HAART, HIV, Metabolic Status