Oxidative stress in HIV patients receiving antiretroviral therapy

Oxidative stress, defined as the imbalance between the oxidant and antioxidant systems, is thought to be associated with the progression of human immunodeficiency virus (HIV) infection. It has been observed that perturbations in antioxidant defense systems, and consequently redox imbalance, are present in many tissues of HIV-infected patients. Existing evidences suggest that oxidative stress may contribute to different stages of viral life cycle including viral replication and its consequences such as inflammatory response and decreased immune cell proliferation. The level of production of free radical species in HIV-1 infected individuals receiving antiretrovirals (ART) including highly active antiretroviral therapy (HAART) was reported to be higher than those who harbor HIV-1 infection without receiving any treatment or normal and healthy subjects. These observations suggest that the HIV-1 infection alone or in combination with introduction of ARV/HAART may induce oxidative stress and further augment HIV-1 pathogenesis. HIV-1 infection and the treatment with antiretrovirals have been found to cause antioxidant enzyme dysfunction in monocytes and central spinal fluid (CSF) leading to cognitive impairment in women. However, the exogenous application of some natural plant products or recent synthetic antioxidants might be useful in scavenging the free radicals. It is expected that their application as an additional strategy may facilitate ARV therapy or HAART for the effective treatment of HIV-1 infected persons or AIDS patients. This review offers a perspective on the current account of oxidative stress in HIV-1 infected individuals and its possible amelioration using suitable antioxidants, plant products and herbal preparations.