Improved antioxidant status among HIV-infected injecting drug users on potent antiretroviral therapy

Low serum antioxidant levels in HIV-infected people have been attributed to altered metabolism associated with excess oxidative stress. We conducted a study to examine serum antioxidant levels in 175 HIV-positive and 210 HIV- negative injecting drug users (IDUs) in Baltimore, Maryland. At the time of data collection, 30 of the HIV-positive IDUs were receiving antiretroviral therapies (ART) including a protease inhibitor (PI), 43 ART without a PI, 22 monotherapies, and 80 not on any ART. Serum antioxidants examined includ ed retinol, alpha-tocopherol and gamma-tocopherol, alpha-carotene and beta- carotene, lycopene, lutein/zeaxanthin, and beta-cryptoxanthin. Mean serum l evels of lycopene and lutein/zeaxanthin were significantly lower in HIV-pos itive IDUs than HIV-negative IDUs. Contrary to the findings in other studie s, however, levels of the remaining antioxidants in HIV-positive study subj ects were not lower than in HIV-negative study subjects. In fact, serum alp ha-tocopherol levels were significantly higher in HIV-positive IDUs than HI V-negative IDUs (medians = 744 mu g/dl and 718 mu g/dl, respectively; p = . 04). Among HIV-positive study subjects, there were significant differences in antioxidant levels by ART regimen. In multivariate models adjusting for injecting drug use, dietary intake, supplement intake, gender, and alcohol intake, significant overall differences by ART regimen were observed for al pha-tocopherol, beta-carotene, and beta-cryptoxanthin. Serum levels of thes e three antioxidants were significantly higher in the PI group than in the other three ART groups combined (p = .0008, 0.02, and 0.02, respectively). These data provide indirect evidence of the effectiveness of PIs in lowerin g oxidative stress levels in HIV-positive IDUs.