Oxidative stress in hemodialysis patients infected with HIV

Abstract

Background: HIV-infected population presents the impaired renal function as a risk factor for death, and comorbid conditions are related in some traits to oxidative stress (OS). Objetive: To analyze the influence of OS in Human Immunodeficiency Virus Infection (HIV) and chronic kidney disease (CKD) by comparing the redox status between HIV patients with and without CKD and HIV hemodialysis patients. Methods: A comparative longitudinal study of the hemodialysis process was developed. The study included 96 individuals divided into four groups namely, supposedly healthy volunteers, patients with HIV infection without renal illnesses, patients with HIV infection and chronic renal disease, and HIV(-) with chronic renal disease. Indexes evaluating redox, hematological, hemochemical, immunologic, and virological aspects were determined. These indexes were also assessed before and after hemodialysis. Results: Viral load, uric acid, creatinine, and urea concentration were significantly (p<0.05) lower after hemodialysis. The two HIV infected groups were significantly different (p<0.05) regarding redox indexes of damage and antioxidant status compared to the group of supposedly healthy volunteers. Significantly increased values (p<0.05) of malondialdehyde, advanced oxidation protein product (AOPP), and peroxidation potential (PP) and significantly lower values glutathione (GSH) (p<0.05) were found after hemodialysis in both groups. In the case of HIV patients, increased values of superoxide dismutase were also found. HIV infected patients under HD tretament exhibited significantly (p<0.05) higher values of AOPP and PP and lower values of GSH than HIV(-) hemodialysis patients after hemodialysis. Conclusion: Oxidative stress occurs in both HIV and CKD conditions, and it is also increased after hemodialysis intervention. Otherwise non-viral control could influence on oxidative status in HIV/CKD patients, that´s why ART affectivities should be monitoring using HIV progression markers. Redox indexes should be diagnosed in HIV hemodialysis patients for treatment and management adjustment.