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Retroviruses have a single-stranded RNA genome that undergoes a special form of replication. Once the retrovirus has entered the host cell, an enzyme called reverse transcriptase synthesizes double-stranded DNA from the retroviral RNA genome. This DNA copy of the genome is then integrated into the host’s genome inside the nucleus via an enzyme called integrase. Consequently, the retroviral genome is transcribed into RNA whenever the host’s genome is transcribed, allowing the retrovirus to...
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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Decrease of vitamin D concentration in patients with HIV infection on a non nucleoside reverse transcriptase

Anali Conesa-Botella1, Eric Florence, Lutgarde Lynen

  • 1Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. aconesa@itg.be.

AIDS Research and Therapy
|November 25, 2010
PubMed
Summary

Vitamin D deficiency is common in HIV patients starting highly active antiretroviral therapy (HAART). Treatment with HAART, particularly non-nucleoside reverse-transcriptase inhibitor regimens, further lowers vitamin D levels, necessitating regular monitoring and supplementation.

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Area of Science:

  • Immunology
  • Endocrinology
  • Infectious Diseases

Background:

  • Vitamin D is crucial for bone health and immune function.
  • Low vitamin D status before highly active antiretroviral therapy (HAART) is linked to HIV progression and mortality in pregnant women.
  • This study investigates vitamin D status in HIV-positive adults initiating HAART.

Purpose of the Study:

  • To prospectively assess vitamin D status in HIV-infected adults before and after 12 months of HAART.
  • To identify factors associated with changes in vitamin D levels during HAART.
  • To evaluate the impact of different HAART regimens on vitamin D status.

Main Methods:

  • Prospective study of HIV-positive adults starting HAART with CD4 T-cell count >100 cells/mm3.
  • Paired plasma samples collected before and after 12 months of HAART.
  • Measurement of 25-hydroxyvitamin D [25-(OH)D] concentrations using defined cut-offs (<20 ng/ml and <30 ng/ml).

Main Results:

  • High prevalence of vitamin D deficiency at baseline (43.7% <20 ng/ml, 70.1% <30 ng/ml).
  • Increased vitamin D deficiency after 12 months of HAART (47.1% <20 ng/ml, 81.6% <30 ng/ml).
  • HAART significantly decreased plasma 25-(OH)D levels (p=0.001), associated with NNRTI regimens and lower body weight.

Conclusions:

  • Vitamin D deficiency is prevalent in HIV-positive individuals.
  • Non-nucleoside reverse-transcriptase inhibitor (NNRTI) therapy exacerbates vitamin D deficiency.
  • Regular vitamin D monitoring and supplementation are recommended for all HIV-infected patients.