Decrease of elevated N,N-dimethylglycine and N-methylglycine in human immunodeficiency virus infection during...

Area of Science:

• Biochemistry
• Virology
• Clinical Medicine

Background:

• Human immunodeficiency virus (HIV)-1 infection affects various metabolic pathways.
• Highly active antiretroviral therapy (HAART) is standard treatment for HIV-1.
• Methionine metabolism and related metabolites may be altered in HIV-1 patients.

Purpose of the Study:

• To investigate fasting serum levels of methionine and related metabolites, vitamin B6, and folate in HIV-1-infected outpatients during HAART.
• To assess changes in these metabolites before and during HAART.
• To explore potential correlations between metabolites and treatment outcomes.

Main Methods:

• Prospective study of 17 therapy-naive HIV-1-infected outpatients.
• Measurements of serum methionine, total homocysteine (tHcy), cystathionine (CYSTA), N,N-dimethylglycine (DMG), N-methylglycine (MG), methylmalonic acid (MMA), total cysteine, vitamin B6, folate, and soluble tumor necrosis factor receptor p75.
• Samples collected at baseline and during HAART (median 100 days), compared with 42 healthy controls.

Main Results:

• Baseline tHcy, MMA, CYSTA, and vitamin B6 levels did not differ significantly from controls.
• A trend towards lower baseline folate levels was observed in HIV-1 patients (P =.06).
• Elevated baseline DMG and MG levels significantly decreased during HAART (P =.0019 and.04, respectively); tHcy increased in 12/17 patients (P =.09).

Conclusions:

• HIV-1-infected patients exhibit altered methionine metabolism, specifically elevated DMG and MG.
• Newly initiated HAART may positively influence these alterations in the betaine pathway.
• Further research is warranted to elucidate the clinical implications of these metabolic changes during HIV-1 treatment.