Antioxidant Micronutrients Intake in People Living with HIV: Implications on Serum Levels and Liver Function

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The Human Immunodeficiency virus (HIV) infection and antiretroviral (ARV) drugs are known to cause oxidative stress which has the tendency to cause damage to body organs such as the liver, affecting their functions. Antioxidants are important to prevent oxidative stress or mitigate it. Even though some of these antioxidants can be acquired from the diet, there is insufficient data about their intakes among PLWH in Ghana. This study therefore sought to assess the intakes of these antioxidant nutrients and the serum levels of two of them, vitamin E and zinc and their possible effect on liver function of people living with HIV (PLWH) attending Antiretroviral Therapy (ART) clinic at the Volta Regional Hospital in Ho. To achieve this, 103 HIV infected adults on antiretroviral therapy were randomly sampled from a list of possible participants. A 3- day 24hr recall and a food frequency questionnaire were employed to assess vitamins A, C, E and zinc as well as energy, carbohydrates, fats and proteins intakes. Serum levels of vitamin E and zinc as well as aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured. Weight and height were measured and BMI calculated. Pre HAART levels of AST and ALT as well as ARV drug intake history were also acquired from hospital records. The results showed that participants had lower median caloric (1680Kcal) and fat (54g) intakes. Median daily dietary intakes of vitamins C, D and E were 54mg, 2μg and 3mg respectively and were lower than recommended intake levels. Serum vitamin E deficiency was observed to be high among the participants (82.5%). The prevalence of underweight, overweight and obesity in the study were 11.7%, 21.4% and 11.7% respectively. There was a significant rise in serum AST levels, from 22.0 IU/L pre HAART to 30.4 IU/L post HAART initiation. Serum levels of ALT significantly decreased from 17.0 IU/L pre- HAART to 13.0 IU/L post-HAART. There was no association between the serum levels of vitamin E and zinc and serum AST and ALT levels. The findings from this study suggest that, serum levels of antioxidant micronutrients, vitamin E and zinc, did not have any effect on liver function.
A thesis submitted to the Department of Biochemistry and Biotechnology in partial fulfilment of the requirements for the award of Master of Philosophy Degree in Human Nutrition and Dietetics