Emmanuel Musisi^1,8, Denis Kasozi Matovu⁸, Andrew Bukenya², Sylvia Kaswabuli¹, Josephine Zawedde¹, Alfred Andama¹, Patrick Byanyima¹, Ingvar Sanyu¹, Abdul Sessolo¹, Emmanuel Seremba³, J Lucian Davis⁶, William Worodria¹, Laurence Huang^1,4,5, Nicholas D Walter^1,7, Harriet Mayanja-Kizza³

1. Infectious Diseases Research Collaboration, Plot 2C Nakasero Hill Road P.O Box 7475, Kampala Uganda.
2. College of Health Sciences, Department of Medical Biochemistry, Makerere University, PO Box 7072, Kampala, Uganda.
3. College of Health Sciences, Department of Medicine, Makerere University PO Box 7072, Kampala, Uganda.
4. HIV, Infectious Diseases, and Global Medicine Division, University of California, San Francisco, San Francisco, CA, USA.
5. Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, USA.
6. Yale University, New Haven, CT, USA.
7. Pulmonary Section, Denver Veterans Affairs Medical Center, Denver, USA.
8. College of Natural Science Department of Biochemistry and Sports Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda.

Emails:

Emmanuel Musisi – emusisi@idrc-uganda.org, Sylvia Kaswabuli – skaswabuli@idrc-uganda.org, Josephine Zawedde – jzawedde@idrc-uganda.org, Alfred Andama – andama.alf@gmail.com, Patrick Byanyima – pbyanyima@idrc-uganda.org, Ingvar Sanyu – singvar@idrc-uganda. org, Abdul Sessolo – asessolo@idrc-uganda.org, J Lucian Davis – lucian.davis@yale.edu, William Worodria – wordria@yahoo.com, Laurence Huang – Laurence.Huang@ucsf.edu, Nicholas D Walter – Nicholas.Walter@ucdenver.com

Andrew Bukenya – bukerah@yahoo.com, Emmanuel Seremba – eseremba@yahoo.com, Harriet Mayanja-Kizza – hmk@chs.mak.ac.ug, Denis

Kasozi Matovu  – dkasozi@cns.mak.ac.ug

Abstract

Background: HIV infection and opportunistic infections cause oxidative stress (OS), which is associated with tissue damage. Anti-retroviral therapy (ART) is used to treat HIV and decrease the risk of opportunistic infections, but it is unclear whether ART reduces OS.  Association of ART with OS was investigated.

Methods: We stratified a convenience sample of frozen serum or plasma from HIV-infected, ART-naïve (n=21); HIV-infected, ART-treated (n=14); HIV and PTB co-infected, ART-naïve (n=21); HIV and PTB co-infected, ART-treated (n=25) patients. Controls (n=21) were HIV-negative adults without TB symptoms. Concentration of OS markers namely: transaminases (ALT and AST), gamma glutamyl transpeptidase (GGT), albumin, total protein, malondialdehyde (MDA), vitamin C, and total anti-oxidant status (TAS) were determined.

Results: AST (p<0.001), GGT (p<0.001), total protein (p=0.001) and MDA (p<0.001) were higher in HIV patients compared to controls. Vitamin C (P<0.0001) and albumin (p<0.01) were lower in HIV-patients relative to controls. ART was only associated with higher albumin (p=0.001), higher GGT (p=0.02) and lower vitamin C (p=0.009). HIV and PTB co-infection was only significantly associated with higher GGT (p=0.01) and AST (p=0.03).

Conclusion: We identified severe OS among HIV-patients. ART was associated with both increased and reduced markers of OS hence suggesting that ART may not attenuate OS.

Keywords: Human immunodeficiency virus, Mycobacterium tuberculosis, Oxidative stress, anti-retroviral therapy, hospitalized patients.

DOI: https://dx.doi.org/10.4314/ahs.v18i3.7

Cite as: Musisi E, Matovu DK, Bukenya A, Kaswabuli S, Zawedde J, Andama A, Byanyima P, Sanyu I, Sessolo A,  Seremba E, Davis JL, Worodria W, Huang L, Walter ND, Mayanja-Kizza H. Effect of anti-retroviral therapy on oxidative stress in Hospitalized HIV infected adults with and without TB. Afri Health Sci. 2018;18(3): 512-522. https://dx.doi.org/10.4314/ahs.v18i3.7

     Effect of anti-retroviral therapy on oxidative stress in hospitalized HIV-infected adults with and without TB. PDF