Plasma homocysteine is not associated with HIV serostatus or antiretroviral therapy in women

BACKGROUND: The effects of HIV serostatus and combination antiretroviral therapy (cART) on plasma homocysteine (HCY) are uncertain. METHODS: Plasma HCY was assayed in a cross-sectional study of 249 HIV-infected and 127 HIV-uninfected women at the Bronx Women's Interagency HIV Study site. RESULTS: Mean plasma HCY was 7.42 ± 2.68 in HIV-infected women and 7.18 ± 2.66 μmol/L in HIV-uninfected women (P = 0.40). Hyperhomocysteinemia (defined as HCY >10 μmol/L) was seen in 16.9% and 13.4% of HIV-infected and HIV-uninfected women, respectively (P = 0.45). Among HIV-infected women, cART use was not associated with HCY level. Compared with the lowest quartile, women with HCY in the highest quartile had lower mean serum vitamin B12 and RBC folate levels. In multivariate analysis that did not include micronutrient levels, age, serum creatinine, and lower CD4% were significantly associated with plasma HCY level in HIV-infected women. CONCLUSIONS: Plasma HCY was not associated with HIV serostatus or use of cART in this cross-sectional study. Reduced availability of folate cofactors for HCY remethylation in HIV-infected women with lower folate intake and decreased health status may influence HCY levels.