Evaluation of the Oxidative Toxicity and Folate Status With Dolutegravir -antiretroviral Therapy in Hiv Disease

Background: Dolutegravir is a widely used integrase inhibitor in antiretroviral therapy for the management of HIV infection due to its potent viral suppression and superior efficacy. However, concerns about its long-term safety have emerged, particularly regarding its potential adverse effects on oxidative balance and micronutrient status. This study aimed to evaluate oxidative stress and antioxidant status by assessing serum levels of malondialdehyde and folate in HIV-positive individuals receiving dolutegravir-based therapy. Methods: This cross-sectional study was conducted at the University of Nigeria Teaching Hospital, Enugu. Participants included HIV-positive individuals on dolutegravir-based therapy for six months, newly initiated patients, and HIV-negative controls. Serum folate levels were measured using chemiluminescence immunoassay, while malondialdehyde levels were determined spectrophotometrically as a marker of oxidative stress. Data were analyzed using descriptive statistics and one-way ANOVA to compare means across groups, with statistical significance set at p < 0.05. Results: A total of 90 participants were enrolled, comprising 30 in each group: control, ART-naïve, and six-month dolutegravir-treated patients. Serum malondialdehyde levels were significantly higher in ART-naïve (5.72 ± 3.61 µmol/L) and six-month treated individuals (8.94 ± 5.03 µmol/L) compared to controls (1.19 ± 0.18 µmol/L). Conversely, serum folate concentrations were significantly lower in the ART-naïve (2.23 ± 1.52 ng/mL) and six-month treated groups (1.89 ± 0.54 ng/mL) compared to controls (11.11 ± 1.31 ng/mL) (p < 0.001). Conclusions: The findings indicate that dolutegravir-based therapy may increase oxidative stress while reducing antioxidant levels in people living with HIV. These alterations in biochemical parameters highlight the importance of routine monitoring of oxidative and micronutrient status in individuals undergoing treatment. Further longitudinal studies are recommended to explore the long-term clinical implications of these changes and to guide potential interventions such as antioxidant supplementation.