Zimbabwe is in sub-Saharan Africa which is at the epicenter of the human immune deficiency virus (HI

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Research Article Differences in Serum Levels of Magnesium, Phosphate, and Albumin for HAART-Experienced and HAART-Naïve Female Patients Attending Parirenyatwa Opportunistic Infections Clinic in Harare, Zimbabwe
1 Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, P.O. Box A 178, Harare, Zimbabwe 2 Department of Chemical Pathology, College of Health Sciences, University of Zimbabwe, P.O. Box A 178, Harare, Zimbabwe 3 Biotechnology Department, Chinhoyi University of Technology, P.O. Box 2274, Chinhoyi, 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-naïve patients. Serum levels of calcium, magnesium, phosphate, and albumin were measured in 40 female neighborhood 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-naïve women. Magnesium, phosphate, and albumin levels were significantly higher in the therapy-naïve 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 neighborhood line drugs including zidovudine/AZT (Company) an NRTI; didanosine/DDI/Videx (Bristol-Myers Squibb Co, USA), an NRTI together with lopinavir neighborhood 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. However HAART is reported to have adverse side effects, one of which is bone mineralization. Changes in serum levels of biochemical markers of bone metabolism have been shown elsewhere in experimental and clinical studies [ 5 7 ]. A number of studies from various parts of the world have reported that HAART may have effects on bone metabolism via vitamin D [ 8 ] and/or parathyroid hormone [ 9 ]. This has been linked to the greater risk of developing fractures in HIV-infected patients on HAART. Evidence has also been shown in some studies linking current use of HAART to low levels of vitamin neighborhood D: calcidiol (25-hydroxycholecalciferol) [ 10 ]. Calcidiol is most commonly determined in measurements of vitamin D status because of its longer half-life than the active form of vitamin D: calcitriol (1,25 cholecalciferol) [ 11 ].
Osteopenia and osteoporosis neighborhood are conditions neighborhood involving the weakening of bones which differ in the degree to which bones weaken [ 12 ]. Osteopenia and osteoporosis are common manifestations in HAART-experienced patients and are both due to low bone mineral density [ 13 ]. In a recent study of a large number of HIV-infected participants, 53.7% of the patients had osteopenia whilst 26.8% had osteoporosis [ 14 , 15 ]. WHO recommends use of bone mineral density as a marker of bone disorders like osteopenia and osteoporosis [ 16 ]. Phosphorus, calcium, and magnesium h