Short-term folinic acid supplementation improves vascular reactivity in HIV-infected individuals: A randomized trial

Abstract Objective HIV-infected individuals present a cluster of conditions that activate or injure the vascular endothelium. The administration of folates may exert beneficial effects on endothelial function in different populations at risk for cardiovascular disease. The aim of this study was to d...

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Published in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2013-06, Vol.29 (6), p.886-891
Main Authors: Grigoletti, Shana S., R.D., M.Sc, Guindani, Grace, M.Sc, Moraes, Ruy S., M.D., Sc.D, Ribeiro, Jorge P., M.D., Sc.D, Sprinz, Eduardo, M.D., Sc.D
Format: Article
Language:English
Subjects:
acids
Acquired immune deficiency syndrome
Adult
Age
AIDS
Antiretroviral Therapy, Highly Active
arteries
at-risk population
Biological and medical sciences
Blood Pressure
Brachial Artery - drug effects
Brachial Artery - metabolism
Brazil
Cardiovascular disease
cardiovascular diseases
CD4 Lymphocyte Count
Cholesterol
clinical trials
Dietary Supplements
Double-Blind Method
Drug therapy
Endothelial function
Endothelium
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
Feeding. Feeding behavior
Female
Folates
Folic acid
Forearm - blood supply
Fundamental and applied biological sciences. Psychology
Gastroenterology and Hepatology
HIV
HIV Infections - drug therapy
HIV Infections - physiopathology
Human immunodeficiency virus
Human viral diseases
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infectious diseases
ingestion
Leucovorin - administration & dosage
Male
Medical sciences
Middle Aged
patients
placebos
Prospective Studies
Regional Blood Flow
therapeutics
Vasodilation
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral Load
women
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Summary:Abstract Objective HIV-infected individuals present a cluster of conditions that activate or injure the vascular endothelium. The administration of folates may exert beneficial effects on endothelial function in different populations at risk for cardiovascular disease. The aim of this study was to determine the effects of 4 wk of folinic acid supplementation on forearm vascular responses during reactive hyperemia in HIV-infected patients under highly active antiretroviral therapy. Methods This was a prospective, randomized, double-blind, placebo-controlled trial to compare the effects of 4 wk of daily ingestion of 5 mg of folinic acid (n = 15) or placebo (n = 15). Participants had to have been on antiretroviral therapy (ART) for at least 6 mo before enrollment, with undetectable viral load, and CD4 cell count >200 cells/mm3 . Vascular function was evaluated with venous occlusion plethysmography at baseline and after 4 wk, for the determination of brachial artery reactive hyperemia, and after isosorbide dinitrate administration. Results The groups were comparable. The mean age of patients was 45 y; there were eight women in each group. There was no difference regarding ART regimen. The supplementation of folinic acid produced a significant improvement in reactive hyperemia (from 14.9 to 21.2 mL•min•100 mL). The same was not observed in placebo group (from 15.3 to 14.6 mL•min•100 mL; group P , 0.017; time P < 0.001; interaction P < 0.001). Endothelium-independent responses remained unchanged. Conclusions Short-term folinic acid supplementation improved vascular reactivity in HIV-infected individuals enrolled in the studied. As folate supplementation is safe and relatively inexpensive, long-term clinical trials should be conducted.
ISSN:0899-9007
1873-1244
DOI:10.1016/j.nut.2013.01.015