**2.1. Subjects**

N = 44 38

N = 44 38

32 35

Hiv infected Healthy persons

Many studies have focused on the role of nutritional supplements to attenuate signs and symptoms of HIV. Of these, some have reported favorable results, while many others have reported no benefit of the selected nutrient. Despite these mixed findings, recommendations for the use of nutritional supplements for the purposes of attenuating HIV are rampant. Based on this background, we have assessed the antioxidant status among HIV-infected patients on

45

**Figure 1.** Catalase level of HIV infected individuals and healthy subjects (k/g Hb)Catalase level of

Catalase (k/g Hb)

4000

242 Pharmacology and Nutritional Intervention in the Treatment of Disease

3000

2000

1000

0


Vitamine E ug/ml

30

20

10

0

oxidative stress after antioxidant supplementation.

**Figure 2.** Vitamin E level of HIV infected individuals and healthy subjects (μg /ml)

HIV infected Healthy

Open clinical trial study was implemented to access antioxidant status among HIV-infected male volunteers in Latvia. Twenty six HIV-positive males (age 35.3 ± 2.5) whose serostatus are known were studied. They were recruited among two non-governmental HIV infected patients' support organizations by "snow-ball" methodology using gatekeepers as contact persons. All participants in the research study were volunteers and their agreement to participate was get through their gatekeepers. The HIV-infected subjects represented a broad range of disease progression. None of the screened subjects had (CD4) T cell counts less than 200x109 /L.

Exclusion criteria for the study groups were as follows: they were over 18 years old, have not used antioxidants as food supplement two months before the study, had no active opportun‐ istic infections or malignancies, had readily mobile, and were no drug users. Any information of partner identifications was not used in the written information

For the control group 10 uninfected males were selected among uninfected friends and relatives of HIV-infected individuals. Control subjects had no acute or chronic illness and were not taking any medications or nutritional supplements.

HIV-infected individuals used food supplements– antioxidant cocktail for 6 month, including 250 mg L-carnitine (Bio-CarnitineTM), 800 µg vitamin A, 15 mg vitamin E, 90 mg vitamin C, 2 mg vitamin B6, 15 mg Zn, 100 mg CoQ10 and 75 µg selenium (organic) (Bio-SeleniumTM+Zn) a day. All subjects underwent an initial screening and after 6 months that included an anthro‐ pometric (weight and height) and biochemical (complete blood count, bilirubin, albumin, from liver panel-alanine aminotranferase (ALT) and alkaline aminotranferase (), from lipid profile total holesterol and triglicerides. All patients were evaluated with regard to the blood antiox‐ idant system, specifically superoxide dismutase (SOD), catalase (CAT) selenium-dependent glutathione peroxidase (GSH-Px, trace element selenium, and α-tocopherol).

Participants will be involved in the study only after obtaining informed consent. The study protocol was approved by the ethics committee of the Latvian Institute of Cardiology for Clinical and Physiological Research, Drug and Pharmaceutics Product Clinical Investigation.

#### **2.2. Laboratory analysis**

After overnight fasting, venous blood samples were collected from all study subjects. Bio‐ chemical determinations were done at the hospital laboratory. CD4+and CD8+cell count was estimated by FACSscan flowcytometry (BD Becton Dickimon). Alanine aminotranferase (ALT) and alkaline aminotranferase were estimated by kinetic reaction (Hitachi 917, Roche Diagnos‐ tics), bilirubin, albumin and total protein by two point colour reaction (Hitachi 917, Roche Diagnostics). From lipid profile total holesterol and triglycerides were estimated by using fermentative colour reaction (Hitachi 917, Roche Diagnostics). Blood antioxidant system was evaluated at Riga Stradinš University laboratory. Selenium and α-Tocophrol concentrations in plasma were measured using fluorometric method. Other measurements were also included such as catalase and GSHPX.

measurements and α-Tocopherol concentration at the initial screening, but differed signifi‐ cantly after 6 months compare to HIV-infected and healthy individuals. Changes of biochem‐ ical measurements (alanine aminotranferase, alkaline aminotranferase, bilirubin, albumin and total protein, total holesterol and triglicerides) were not significant between groups of HIVinfected and healthy individuals as well as at the initial screening and after 6 months after use of food supplements. Additionally, two HIV-infected individuals from 26 involved in the study reported that after the use of antioxidant cocktail, gingival bleeding was stopped. One reported this symptom for two years before the study and one reports half a year this problem

Impact of CoQ10, L-Carnitine and Cocktail Antioxidants on Oxidative Stress Markers in HIV Patients — Mini Review…

n Mean±SE n Mean±SE p

http://dx.doi.org/10.5772/58415

245

healthy 10 50.9±1.6 9 49.5±0.7 NS

healthy 10 317.4±34.6 9 377.7±13.1 NS

healthy 10 1293.7±36.6 9 1172.8±30.4 0.023

healthy 10 1.4±0.0 9 1.4±0.0 NS

healthy 10 9.2±1.0 9 7.4±0.1 NS

healthy 10 51±3.0 9 53.9±3.1 NS

healthy 10 3.4±0.2 9 3.4±0.2 NS

0.013 NS

NS 0.008

NS NS

NS 0.003

NS NS

NS 0.000

**Measuremetns groups Baseline After 6 months**

GSHPX infected 25 46.5±1.1 19 45.6±1.3 NS

CAT infected 26 1023.5±164.1 19 350.3±22.3 0.01

SOD infected 25 1074±68.3 19 1419.3±56.6 0.001

TAS infected 24 1.0±0.0 17 1.5±0.0 0.001

VITE infected 26 10.8±0.8 19 13.2±1.2 NS

SE infected 25 47.4 21 64.0±3.7 0.000

MDA infected 24 3.5±0.1 17 5.1±0.3 0.000

**Table 2.** Effect of antioxidants supplementation on antioxidant enzymes, selenium, vitamin E and lipid peroxidation in

p 0.036 NS

before study.

HIV patients.

#### **2.3. Statistical analyses**

Using the SPSS 14.0 for Windows software standard version, statistical analyses were per‐ formed. All group data are expressed as means ± SEMs. The HIV-positive group was compared with the seronegative control subjects by using one way ANOVA. The minimal level of significance was identified at *P* < 0.05. All patients were evaluated with regard to the blood antioxidant system, specifically superoxide dismutase (SOD) and glutathione peroxidase.
