Pilot study on the efficacy and safety of berberine in people with metabolic syndrome and human immunodeficiency virus infection

BACKGROUND

Antiretroviral therapy has increased the life expectancy of people living with HIV. However, this increase is not free of comorbidities, and metabolic syndrome is one of the most prevalent. Berberine is an alkaloid nutraceutical that has been shown to ameliorate metabolic disorders such as prediabetes, polycystic ovary syndrome, and non-alcoholic fatty liver disease. However, it has not been tested in HIV infection. Therefore, we conducted a randomized controlled trial to evaluate the efficacy of berberine in improving metabolic syndrome.

METHODS AND RESULTS

In this double-blind, placebo-controlled trial, adults living with HIV under virological suppression and metabolic syndrome received either berberine 500 mg TID or placebo for 20 weeks. The primary outcomes were a composite of weight reduction, insulin resistance decrease, and lipid profile improvement. A total of 43 participants were randomized (22 in the berberine group and 21 in the placebo group); 36 participants completed the follow-up and were analyzed. The berberine group showed a reduction in weight and body mass index, lower insulin resistance, and a reduction in TNF-alpha. The control group had higher total cholesterol, c-LDL, and IL-6 concentration.

CONCLUSION

In people living with HIV under virological suppression, berberine was safe and improves clinical and biochemical components of metabolic syndrome. However, further studies with more participants and longer intervention periods need to be explored.

P0644RELATIONSHIP BETWEEN THE PRESENCE OF INFECTION DISEASE AND CLINICAL OUTCOMES OF PATIENTS WITH CARDIORENAL SYNDROME TYPE 1

Background and Aims: Introduction

Cardiorenal Syndrome type 1 (CRS-1) can be triggered by an infection. The pathophysiological basis is vascular congestion, which is why it has been treated with different strategies of diuretics, but in the presence of infection, the inflammatory, neurohormonal and hemodynamic effects can compromise the efficacy of the diuretic therapy and potentially worsen clinical evolution. Here we compare the clinical evolution during the hospitalization of CRS-1 patients with and without infection.

Method

This is a retrospective cohort study conducted in the Hospital Civil of Guadalajara “Fray Antonio Alcalde”, from January 2015 to September 2018. Conducted in CRS-1 patients, we showed the clinical evolution and diuretic strategies analyzed according to the presence or absence of infection. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.

Results

We identified 63 patients classified as having CRS-1, 28 (44.4%) were classified as having an infectious disease. The mean age was 62 years (±14.6) and 58 (±12.4) in the group with infection and no infection, respectively. There were no statistically significant differences between the clinical outcomes of both groups. The median length of hospital stay was 8 days in the group with infection and 7 days in the group without infection (p=0.065). Three patients (10.7%) of the group with infection received renal replacement therapy and 1 patient (2.9%) in the group without infection (p=0.315). In the group with infection, 2 patients died (7.1%), whereas in the uninfected group there were no deaths (p=0.194). sCr values tend to diminish in a similar manner in both groups. Serum sodium tend to increase during the hospitalization but there was no significant difference between the groups. We found that all patients received furosemide at least during the first five days of hospitalization and the strategy of the diuretic chosen was similar between groups.

Conclusion

We showed that the clinical evolution of patients with CRS-1 is similar in the presence or absence of infection. We anticipate that this study may be a reason to expand knowledge in patients with CRS-1 and the presence of infection.