Plasma homocysteine in human immunodeficiency virus infected patients

Weak hyperhomocysteinemia is a risk factor for the development of atherothrombotic vascular complication. Their plasma levels are affected by nutritional and pharmacologic factors, tobacco, certain metabolic state and gender. In HIV+ patients, the wasting syndrome or chronic diarrheas could affect the levels of homocysteine (Hcy), as well as some adverse effects of the new antiretroviral therapies (lipodystrophy syndrome: insulin resistance and/or dislypemia). The levels of Hcy were evaluated in 53 HIV+ patients without any treatment and in 75 HIV+ under treatment with and without metabolic disturbances (n=43; n=32, respectively). Control group: 32 HIV negative individuals. We looked for association with folic acid, vitamin B12, lipids, insulin resistance status, activation platelets (soluble P-selectin) and endothelial injury (soluble trombomodulin) markers; and also their relation with tabacco, disease status and kind of treatment. There were no statistically significant differences in the mean levels of vitamin B12, Hcy, P-selectin and insulin resistance status between the control group and the HIV+; 16.4% of the 128 HIV+ patients had Hcy 15 mumol/L and the control group had 12.9 % (p=0.617). The levels of Hcy correlated with the levels of folic acid (Rho=-0.314, p<0.01) and age (Rho=0.277, p<0.01) among HIV+. There were no statistically significant differences in the levels of Hcy neither between smokers and non smokers (p=0.452) nor between HIV+ AIDS or HIV+ no AIDS (p=0.774) nor with the use of certain antiretrovirals (p=0.801). The hyperhomocysteinemia (a well known atherothrombotic risk factor) is not frequently associated with HIV infected patients. The levels of Hcy would not seem to be influenced either by the HIV condition or by the antiretroviral treatments or their adverse effects.