Differences in Serum Levels of Magnesium, Phosphate, and Albumin for HAART-Experienced and HAART-Na？ve Female Patients Attending Parirenyatwa Opportunistic Infections Clinic in Harare, Zimbabwe
Antiretroviral therapy inhibits HIV replication, maintains health, and preserves life. However, both antiretroviral therapy and HIV infection have been reported to have short- and long-term effects on bone metabolism. A cross-sectional study was performed to compare serum bone profiles in HIV positive patients on highly active antiretroviral therapy and compare them to therapy-na？ve patients. Serum levels of calcium, magnesium, phosphate, and albumin were measured in 40 female participants on highly active antiretroviral therapy, recruited sequentially from Parirenyatwa Opportunistic Infections Clinic, Harare, Zimbabwe. The 40 women were matched for age with 40 antiretroviral therapy-na？ve women. Magnesium, phosphate, and albumin levels were significantly higher in the therapy-na？ve than in therapy-experienced patients. There was no statistically significant difference in calcium levels of the two groups of women. Evidence from this study suggests that highly active antiretroviral therapy lowers levels of magnesium, phosphate, and albumin but has no effect on levels of serum calcium. 1. Introduction Zimbabwe is in sub-Saharan Africa which is at the epicenter of the human immune deficiency virus (HIV) epidemic. According to UNAIDS the prevalence of HIV in Zimbabwe has decreased to about 1 in 10 adults (2012) from a high one of almost 1 in 4 in 2002 [1]. While the decline is commendable HIV infection still remains a major problem in Zimbabwe with 14.3% of adults being HIV positive [2]. The high disease burden of HIV has necessitated a rapid increase in the use of highly active antiretroviral therapy (HAART). As of 2012, over 476 thousand HIV-infected Zimbabweans were on HAART compared to only 8000 in 2003 [1]. In the Zimbabwe National Program, first line drug combinations include a dual combination of tenofovir/TDF/disoproxil fumarate (Gilead Sciences, USA); a nucleoside reverse transcriptase inhibitor (NRTI) and lamivudine/3TC/2,3 dideoxy-3-thiacytidine (GlaxoSmithKline and Pfizer, UK), an NRTI and a triple combination of tenofovir, lamivudine with nevirapine/XR/viramune (Boehringer Ingelheim, USA) a non-nucleoside reverse Transcriptase inhibitor (NNRTI) [3, 4]. In the event of treatment failure the patients are treated with second line drugs including zidovudine/AZT (Company) an NRTI; didanosine/DDI/Videx (Bristol-Myers Squibb Co, USA), an NRTI together with lopinavir and ritonavir; protease inhibitors (PIs) also known as kaletra/aluvia (Abbot Laboratories) [3]. HAART has reduced both the morbidity and mortality of HIV-infected people due to AIDS.
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