Abstract:
Monitoring the progression of HIV infection to full-blown acquired immune deficiency syndrome (AIDS)
and assessing responses to treatment will benefit greatly from the identification of novel biological
markers especially since existing clinical indicators of disease are not infallible. Nuclear magnetic
resonance spectroscopy (NMR) and mass spectrometry (MS) are powerful methodologies used in
metabonomic analyses for an approximation of HIV-induced changes to the phenotype of an infected
individual. Although early in its application to HIV/AIDS, (biofluid) metabonomics has already identified
metabolic pathways influenced by both HIV and/or its treatment. To date, biofluid NMR and MS data
show that the virus and highly active antiretroviral treatment (HAART) mainly influence carbohydrate
and lipid metabolism, suggesting that infected individuals are susceptible to very specific metabolic
complications. A number of well-defined biofluid metabonomic studies clearly distinguished HIV
negative, positive and treatment experienced patient profiles from one another. While many of the
virus or treatment affected metabolites have been identified, the metabonomics measurements were
mostly qualitative. The identities of the molecules were not always validated neither were the statistical
models used to distinguish between groups. Assigning particular metabolic changes to specific drug
regimens using metabonomics also remains to be done. Studies exist where identified metabolites have
been linked to various disease states suggesting great potential for the use of metabonomics in disease
prognostics. This review therefore examines the field of metabonomics in the context of HIV/AIDS,
comments on metabolites routinely detected as being affected by the pathogen or treatment, explains
what existing data suggest and makes recommendations on future research.