European Journal of Cardiovascular Medicine

Objective: The introduction and use of antiretroviral therapies (ART) has revolutionized the management and treatment of Human Immunodeficiency Virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV/ AIDS globally resulting in increased life expectancy. Current treatment guidelines by WHO recommend the use of a combination of at least 3 ARV drugs which include: 2 Nucleoside Reverse Transcriptase Inhibitors (NRTIs) combined with 1 medication from either of the 2 remaining classes; the Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) or the Protease Inhibitors (PIs). Micronutrients and electrolytes deficiencies are prevalent among HIV-infected populations. The use of Highly Active Antiretroviral Therapy (HAART) on the other hand has been shown to increase the life expectancy of HIV infected individuals. The present study was designed to determine the effects of HAART on serum micronutrients and electrolytes concentrations in HIV positive patients. Materials and Methods: A prospective randomized controlled clinical study was conducted in the with 231 HIV+ adults with low plasma zinc levels (<0.75 μg/ml), randomly assigned into zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo, for 18 months. The primary endpoint was immunological failure. HIV-viral load and CD4+ cell count were determined every 6 months. Questionnaires, pill-counts, plasma zinc and C-reactive protein (hsCRP) were used to monitor adherence with study supplements and ART. Intent-to-treat analysis utilized multiple-event analysis, treating CD4+ cell count <200 cells/mm3 as recurrent immunological failure event. Cox proportional-hazard models and the general-linear model were used to analyze morbidity and mortality data. Results: Severe, moderate and mild malnutrition were detected in 15%, 38% and 24% of human immunodeficiency virus infected individuals respectively. Compared with the healthy control group, serum level of zinc and selenium in the human immunodeficiency virus infected subjects were significantly lower (P = 0.01 and P = 0.02 respectively). Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: ART treatment did not complement zinc status in HIV infection while improving CD4+ T-cell count, hence the need to consider supplementation