Comparative and correlative levels of copper, zinc, with ceruloplasmin and metallothionein in art-HIV infected and non-art-HIV infected subjects: A cross-sectional study.

Authors

  • Dr. Nageswara Rao. T Associate Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
  • A.Srinivas Assistant Professor, Department of Pharmacology, Bhaskar Medical College , Moinabad, Telangana, India
  • Dr. Manju Thomas Senior Lecturer, Department of Clinical Pharmacology, St Joseph College of Health and Allied Sciences, Dar es Salaam, Tanzania
  • Dr . Yakaiah Vangoori Professor, Department of Pharmacology, MallaReddy Medical Collage for Women, Suraram, Hyderabad,Telangana, India
  • Dr . Suresh Babu Sayana Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2146

Keywords:

HIV, antiretroviral therapy, zinc, copper, ceruloplasmin, metallothionein, lipid profile, glycaemic parameters

Abstract

Background:
Trace elements such as copper and zinc, along with their transport proteins ceruloplasmin and metallothionein, play crucial roles in immune function and oxidative balance. Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) alter these micronutrient levels, influencing disease progression and metabolic complications.

Objectives:

To compare and correlate copper, zinc, ceruloplasmin, and metallothionein levels between ART-HIV–infected and non-ART-HIV–infected subjects and evaluate associated biochemical and metabolic parameters.

Methods:

A cross-sectional study was conducted on 200 HIV-infected subjects (100 on ART, 100 not on ART) attending a tertiary care center. Demographic, physical, lipid, glycaemic, and trace element parameters were assessed using standard biochemical methods. Statistical analysis was performed with SPSS software; p < 0.05 was considered significant.

Results:

The mean age of participants was 55.5 ± 6.2 years, with a male-to-female ratio of 1.3:1. BMI was significantly higher in ART-HIV subjects (p < 0.0001), while blood pressure and age were comparable between groups. ART-HIV subjects exhibited lower total cholesterol and LDL but higher HDL compared with non-ART-HIV patients. Fasting blood sugar was significantly lower in the ART group (p < 0.001), though insulin levels showed no difference. Notably, serum zinc levels were markedly reduced in ART-HIV subjects (p < 0.0001), whereas copper, ceruloplasmin, and metallothionein were significantly elevated (p < 0.05). A positive correlation was observed between copper and ceruloplasmin, and a negative correlation between zinc and ceruloplasmin.

Conclusion:

HIV infection and ART significantly alter trace element balance and related biomarkers. ART appears beneficial in improving lipid and glycaemic profiles but is associated with zinc depletion and compensatory increases in copper, ceruloplasmin, and metallothionein.

Recommendations:

Routine monitoring of trace elements in HIV-infected patients is essential. Zinc supplementation and dietary counseling may mitigate long-term metabolic complications and improve immune resilience.

Author Biographies

Dr. Nageswara Rao. T , Associate Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India

is currently serving as an Associate Professor of Pharmacology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, East Godavari District, Andhra Pradesh, India. He holds a doctoral degree in Medical Pharmacology from the prestigious Index Medical College and Research Institute, Madhya Pradesh. With over 16 years of teaching experience in various medical institutions, Dr. Nageswararao has made significant contributions to the field of pharmacology. His academic work includes nine research publications in reputed national and international journals, including one article indexed in PubMed. His dedication to research and education continues to enrich the academic and clinical landscape of medical pharmacology.ORCID iD:https://orcid.org/0009-0005-1638-6897

A.Srinivas, Assistant Professor, Department of Pharmacology, Bhaskar Medical College , Moinabad, Telangana, India

is an Assistant Professor in the Department of Pharmacology at Bhaskara Medical College, Hyderabad, Telangana, India. He obtained his Master’s degree in Medical Pharmacology from Kamineni Institute of Medical Sciences (KIMS). With over 17 years of teaching experience across various medical colleges, he has actively contributed to academic research and published 10 papers in reputed national and international journals.ORCID iD: https://orcid.org/0000-0002-4955-9839

Dr. Manju Thomas, Senior Lecturer, Department of Clinical Pharmacology, St Joseph College of Health and Allied Sciences, Dar es Salaam, Tanzania

Thomas is an accomplished Pharmacologist with more than 16 years of teaching and research experience across India, the United Kingdom, and East Africa. She holds a Bachelor of Pharmacy (B.Pharm) from Bangalore University, a Master of Science in Clinical Pharmacology from the University of Aberdeen, UK, and a Ph.D. in Pharmacology from Sunrise University, Alwar, India. Her doctoral research focused on the healing properties of Ageratum conyzoides Linn and its antimicrobial potential in skin infections.

Dr. Thomas has served in progressively senior academic roles, including her current position as Senior Lecturer, Department of Clinical Pharmacology, St Joseph College of Health and Allied Sciences, Dar es Salaam, Tanzania. Previously, she was Associate Professor and Head of Pharmacology at Kampala International University, Tanzania, where she played a pivotal role in elevating the Department of Pharmacy into a full-fledged Faculty of Pharmacy. She also held faculty and leadership positions at the International Medical and Technological University (IMTU), Tanzania.

Her earlier career includes valuable research and industry experience as a Research Assistant in the Department of Medicine and Therapeutics at the University of Aberdeen, UK, and as Project Leader in Genetic Toxicology at Charles River Laboratories, Edinburgh, UK. These roles provided her with extensive expertise in molecular pharmacology, toxicology, chemoprevention, and laboratory management under GLP and GCP standards.

With more than 10 peer-reviewed publications in national and international journals, Dr. Thomas’s research contributions span cancer chemoprevention, polyamine metabolism, diabetes models, drug formulation, complementary medicine, and addiction studies. She has also contributed book chapters and presented at international conferences. In addition, she has supervised three master’s students and nearly thirty undergraduates, reflecting her strong commitment to mentorship.

Dr. Thomas is a member of the British Pharmacological Society (UK) and the Kerala Pharmacy Council (India). She has also served as Editor of the Indian Journal of Mednodent and Allied Sciences (IJOMDAS). Her academic profile is enriched by international workshops and certifications in neuroscience, genetics, pharmacovigilance, GLP, and clinical research methods.

Beyond academia, Dr. Thomas is deeply engaged in current research projects on antimicrobial misuse, lifestyle influences on endometriosis, and sanitation-related child health issues in Tanzania. Her achievements highlight not only her scientific rigor but also her commitment to addressing pressing global health challenges.

In addition to her academic and research pursuits, she has a keen interest in literature, classical music, and creative writing, having won prizes in essay and elocution competitions. Her career exemplifies a blend of scholarship, leadership, and mentorship, making her a distinguished figure in the field of Pharmacology.

Dr . Yakaiah Vangoori, Professor, Department of Pharmacology, MallaReddy Medical Collage for Women, Suraram, Hyderabad,Telangana, India

is a Professor of Pharmacology at Malla Reddy Medical College for Women, Hyderabad, Telangana. He earned his Doctoral degree in Medical Pharmacology from the prestigious Sri Ramachandra Medical College and Research Institute, Chennai. With 17 years of teaching experience in medical institutions, Dr. Vangoori has made significant contributions to the field of pharmacology. He has published 35 research papers in reputed national and international journals, including 8 articles indexed in PubMed. His research expertise lies in the use of animal models for studying diabetes, inflammation, and obesity.

ORCID iD: https://orcid.org/0000-0002-3539-7680

Dr . Suresh Babu Sayana, Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India

 is an Associate Professor of Pharmacology at Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India. He earned his Doctoral degree in Medical Pharmacology from the esteemed Krishna Institute of Medical Sciences Deemed University (KIMSDU), Karad, Maharashtra. With over 16 years of teaching experience in various government and private medical institutions across Andhra Pradesh, Karnataka, and Telangana, Dr. Sayana has made notable academic and research contributions. He has authored 60 international research publications, including 20 articles indexed in PubMed and 14 in Scopus-indexed impact factor journals. His core research interests lie in ethnopharmacology, cardiology, Internal Medicine, and pharmacological review literature. Dr. Sayana secured 2nd rank in the Telangana State Public Service Commission (TSPSC) recruitment for the post of Assistant Professor in 2019. He was honored with the Best Teacher Award by the Government of Karnataka for his excellence in medical education. In 2025, he received the distinguished Cureus Laureate Award from the Cureus Journal of Medical Science in recognition of his outstanding contributions to scientific research.ORCID iD: https://orcid.org/0000-0003-4971-4007

References

Baissary J, Koberssy Z, Wu Q, Sattar A, Atieh O, Daher J, et al. Zinc Supplementation, Inflammation, and Gut Integrity Markers in HIV Infection: A Randomized Placebo-Controlled Trial. Nutrients. 2025 May 14;17(10):1671. doi: 10.3390/nu17101671. PMID: 40431411; PMCID: PMC12114530. https://doi.org/10.3390/nu17101671

Rodrigues SS, Bocchi M, de Oliveira DM, Fernandes EV. Importance of trace elements in the immunometabolic health of people living with HIV/AIDS: a literature review. Mol Biol Rep. 2024 Dec 21;52(1):71. doi: 10.1007/s11033-024-10186-4. PMID: 39708271. https://doi.org/10.1007/s11033-024-10186-4

Proikaki S, Georgiadis N, Sergentanis TN, Kornarou E, Vassilakou T. Nutritional Status of Adult People Living with HIV: A Narrative Review. Diseases. 2025 Feb 14;13(2):56. doi: 10.3390/diseases13020056. PMID: 39997063; PMCID: PMC11854654. https://doi.org/10.3390/diseases13020056

Onwuli D, Waribo-Anthony H, Anyalebechi O, Ugochukwu C. CD4+ T-cell count, serum zinc, copper, and selenium levels in HIV sero-positive subjects on ART and ART naïve subjects in Port Harcourt, Nigeria. J Biosci Med. 2022;10:105-16. doi:10.4236/jbm.2022.105010 https://doi.org/10.4236/jbm.2022.105010

Weiselberg J, Niu M, Hernandez CA, Fox HS, Calderon TM, Berman JW. Methamphetamine Induces Metallothionein 1 Expression and an Inflammatory Phenotype in Primary Human HIV-Infected Macrophages. International Journal of Molecular Sciences. 2025; 26(18):8875. https://doi.org/10.3390/ijms26188875

Nedić O, Šunderić M, Robajac D, Miljuš G, Četić D, Penezić A. Major trace elements and their binding proteins in the early phase of Covid-19 infection. J Biol Inorg Chem. 2022 Mar;27(2):261-269. doi: 10.1007/s00775-022-01931-w. Epub 2022 Feb 12. PMID: 35150336; PMCID: PMC8853275. https://doi.org/10.1007/s00775-022-01931-w

Stiles LI, Ferrao K, Mehta KJ. Role of zinc in health and disease. Clin Exp Med. 2024 Feb 17;24(1):38. doi: 10.1007/s10238-024-01302-6. PMID: 38367035; PMCID: PMC10874324. https://doi.org/10.1007/s10238-024-01302-6

Wang Y, Sun Y, Jie T, Wang M, Zhang S, Yang H, et al. Association between serum Copper-Zinc-Selenium mixture and multiple health outcomes. Bioact Mater. 2025 Apr 24;50:432-442. Doi: 10.1016/j.bioactmat.2025.04.004. PMID: 40309256; PMCID: PMC12041763. https://doi.org/10.1016/j.bioactmat.2025.04.004

Asemota EA, Okafor IM, Okoroiwu HU, Ekong ER, Anyanwu SO, Efiong EE, et al. Zinc, copper, CD4 T-cell count, and some hematological parameters of HIV-infected subjects in Southern Nigeria. Integr Med Res. 2018 Mar;7(1):53-60. doi: 10.1016/j.imr.2018.01.008. Epub 2018 Feb 13. PMID: 29629291; PMCID: PMC5884009. https://doi.org/10.1016/j.imr.2018.01.008

Charkiewicz AE. Is Copper Still Safe for Us? What Do We Know and What Are the Latest Literature Statements? Current Issues in Molecular Biology. 2024; 46(8):8441-8463. https://doi.org/10.3390/cimb46080498

Gandhi RT, Landovitz RJ, Sax PE, Smith DM, Springer SA, Günthard HF, et al. Antiretroviral Drugs for Treatment and Prevention of HIV in Adults: 2024 Recommendations of the International Antiviral Society-USA Panel. JAMA. 2025 Feb 18;333(7):609-628. doi: 10.1001/jama.2024.24543. PMID: 39616604. https://doi.org/10.1001/jama.2024.24543

Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clin Infect Dis. 2010 Jun 15;50(12):1653-60. doi: 10.1086/652864. PMID: 20455705; PMCID: PMC2874106. https://doi.org/10.1086/652864

Downloads

Published

2025-09-30

How to Cite

Rao T, . N. ., A.Srinivas, Dr .Manju Thomas, Dr. Yakaiah Vangoori, & Sayana, D. S. B. . (2025). Comparative and correlative levels of copper, zinc, with ceruloplasmin and metallothionein in art-HIV infected and non-art-HIV infected subjects: A cross-sectional study. Student’s Journal of Health Research Africa, 6(9), 10. https://doi.org/10.51168/sjhrafrica.v6i9.2146

Issue

Section

Section of Pharmacology and Chemotherapeutics