Correlation of copper/zinc ratio with superoxide dismutase activity and neutrophil-to-lymphocyte ratio in human immunodeficiency virus type 1 (HIV-1) infected subjects

Introduction
The important role of nutrition in the pathogenesis of human immunodeficiency virus type-1 (HIV-1) infection has not been sufficiently addressed in sub-Sahara Africa, where the prevalence of HIV infection is high. This study correlates copper-to-zinc ratio with activities of superoxide dismutase and calculated neutrophil-to-lymphocyte ratio in HIV-1-infected subjects.

Material and methods
In the study, there were 120 confirmed HIV-1 positive subjects and 100 HIV-1 negative ambulatory healthy controls. Complete blood count, clusters of differentiation (CD4+) lymphocyte count, serum superoxide dismutase (SOD), catalase, copper, and zinc were evaluated using hematology analyzer, FACS flow cytometer, enzyme-linked immunosorbent assay, and atomic absorption spectrophotometer, respectively. Correlation between the measured variables was completed using Pearson correlation coefficient.

Results
Serum copper (p < 0.001), catalase (p < 0.05), and neutrophil-to-lymphocyte ratio (NLR) (p < 0.001) were significantly higher, while serum zinc (p < 0.001) was lower in HIV-1 positive than control subjects. Copper/zinc ratio correlated with SOD (r = –0.228; p < 0.02), CD4+ (–0.235; p < 0.02), and NLR (r = 0.198; p < 0.05) in HIV infected subjects.

Conclusions
Copper/zinc ratio correlated with NLR, SOD, and CD4+ cell count. Because of the adverse effects associated with imbalance of copper and zinc levels, nutritional status, antioxidant defense mechanism, and inflammatory markers may be assessed periodically in HIV-1-infected patients.