Ramadan fasting reduces high-sensitivity C-reactive protein among HIV-infected patients receiving antiretroviral therapy

Alvina Widhani; Evy Yunihastuti; Siti Setiati; Fiastuti Witjaksono; Teguh H Karjadi

doi:10.3389/fnut.2022.964797

Ramadan fasting reduces high-sensitivity C-reactive protein among HIV-infected patients receiving antiretroviral therapy

Front Nutr. 2023 Jan 6:9:964797. doi: 10.3389/fnut.2022.964797. eCollection 2022.

Authors

Alvina Widhani^{1

2}, Evy Yunihastuti^{1

2}, Siti Setiati^{3

4}, Fiastuti Witjaksono⁵, Teguh H Karjadi^{1

2}

Affiliations

¹ Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Jakarta, Indonesia.
² HIV Integrated Clinic, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, Jakarta, Indonesia.
³ Geriatric Division, Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Jakarta, Indonesia.
⁴ Center for Clinical Epidemiology and Evidence Based Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Jakarta, Indonesia.
⁵ Department of Clinical Nutrition, Faculty of Medicine, Dr. Cipto Mangunkusumo General Hospital, Universitas Indonesia, Central Jakarta, Jakarta, Indonesia.

Abstract

Background: Inflammatory conditions and oxidative stress increase in HIV infection, and inflammation increases the risk of cardiovascular disease. Ramadan fasting is known to reduce inflammation and oxidative stress in diabetic patients. This study examined the effects of Ramadan fasting on high-sensitivity C-reactive protein (hs-CRP) levels and total antioxidant status (TAOS) in HIV patients on antiretroviral therapy (ART).

Methods: This was a prospective cohort study comparing HIV-infected patients on stable ART who fasted throughout Ramadan to HIV-infected patients who did not fast during Ramadan. Inclusion criteria were men aged 20-40 years, taking first-line ART for at least 6 months, Muslims intent to fast for Ramadan, no current hospitalization because of acute conditions and not being treated for opportunistic infections.

Results: After 2 weeks, hs-CRP had decreased significantly in the fasting group (-0.41 mg/L [IQR = -1; 0.10]) compared to the non-fasting group (0.20 mg/L [IQR = -0.30; 1.50]) (p = 0.004). The linear regression analysis has shown that Ramadan fasting contributed to 10.10% of the variance in hs-CRP value (R ² = 0.101) and decreased its value by 0.317 points (B = -0.317). Changes in TAOS did not significantly different (p = 0.405) between the fasting group (0.05 mmol/L [IQR = -0.03; 0.12]) and the non-fasting group (0.04 mmol/L [IQR = -0.13; 0.36]). In the fasting group, there were significant changes in polyunsaturated fatty acid consumption (p = 0.029), body weight (p = 0.001), cigarette smoking (p = 0.001), and sleeping duration (p = 0.001).

Conclusion: Ramadan fasting reduces hs-CRP concentrations among HIV patients on ART.

Keywords: C-reactive protein; HIV; Ramadan; fasting; inflammation.