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Singhato A, Booranasuksakul U, Khongkhon S, Rueangsri N. Effectiveness of the Therapeutic Lifestyle Change Diet Intervention to Improve Biochemical Markers of Cardiovascular Diseases in HIV-Infected Patients with Dyslipidemia. ANNALS OF NUTRITION & METABOLISM 2024; 80:202-210. [PMID: 38631311 DOI: 10.1159/000538578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION This randomized controlled trial study aimed to investigate the effectiveness of therapeutic lifestyle change (TLC) diet intervention by the registered dietitians. METHODS Eighty-two people living with HIV (PLHIV) with dyslipidemia were randomly allocated to the intervention group as well as another 82 PLHIV with dyslipidemia to the control group. Participants in the intervention group were instructed to meet the registered dietitians every 2 weeks at weeks 0, 2, 4, 6, and 12 (a totally of 12 weeks) to receive individual medical nutrition therapy according to the TLC diet principles, while the participants in the control group only received routine health care service. RESULTS Triglycerides, total cholesterol, and LDL cholesterol of the intervention group were significantly lower than those of the control group at the endpoint (p < 0.05). In addition, these biomarkers and C-reactive protein of the intervention group were significantly lower when compared with their baseline (p < 0.05). The overall dietary habits of participants in the intervention group were significantly improved at the end of the study (p < 0.05). CONCLUSION The medical nutrition therapy intervention based on the TLC diet is effective in improving blood lipid profiles among PLHIV with dyslipidemia.
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Affiliation(s)
- Alongkote Singhato
- Nutrition and Dietetics Division, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Uraiporn Booranasuksakul
- Nutrition and Dietetics Division, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
| | - Somjet Khongkhon
- Thai Traditional Medicine Division, Faculty of Thai Traditional and Alternative Medicine, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand
| | - Narisa Rueangsri
- Nutrition and Dietetics Division, Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
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Enyang D, Sonibare MA, Tchamgoue AD, Tchokouaha LRY, Yadang FS, Nfor GN, Kom CW, Betote PDH, Tchinda CF, Tiogo SSK, Agbor GA. Protective and Ameliorative Effects of Hydroethanolic Extract of Piper nigrum (L.) Stem against Antiretroviral Therapy-Induced Hepatotoxicity and Dyslipidemia in Wistar Rats. J Toxicol 2024; 2024:5811080. [PMID: 38357682 PMCID: PMC10866638 DOI: 10.1155/2024/5811080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 12/05/2023] [Accepted: 12/30/2023] [Indexed: 02/16/2024] Open
Abstract
Antiretroviral therapy (ART) has revolutionized the lives of people living with HIV/AIDS by overall improving their quality of life and increasing life expectancy. However, ART-associated hepatotoxicity and metabolic disorders in HIV/AIDS patients are growing concerns to clinicians, especially due to the long-term use of the drugs. This study reported on the phytochemical and pharmacological profile of hydroethanolic extracts of Piper nigrum stem (PNS) and evaluated its protective effect against tenofovir/lamivudine/efavirenz (TLE)-induced hepatotoxicity and dyslipidemia in Wistar rats. Cytotoxic, antioxidant, and anti-inflammatory assays were performed on PNS. Thirty-six rats divided into 6 groups of 6 animals/group were administered: distilled water, 17 mg/kg TLE, 17 mg/kg TLE and 100 mg/kg silymarin, 17 mg/kg TLE, and Piper extract (200 mg/kg, 400 mg/kg, or 800 mg/kg) orally for 28 days. The body weight of animals was recorded every 7 days. On Day 29, the rats were sacrificed, and blood samples were collected for hematological and biochemical tests. Portions of the liver and kidneys were collected for histological evaluation, while liver homogenates were prepared from the rest to measure antioxidant enzymes. PNS possessed in vitro cytotoxic, antioxidant, and anti-inflammatory activities. A significant decrease (p < 0.05) in the body weight of rats treated with PNS was observed. A significant high platelet count (p < 0.05) was observed in the PNS800 mg/kg group. A considerable decrease in alkaline phosphatase and triglycerides was observed in the silymarin and PNS group compared to the TLE-only group. The findings also show a significant increase in catalase and glutathione in the TLE-only group compared to the normal group, while SOD decreased. Histological observations revealed normal hepatic and renal tissues in the silymarin, and PNS-treated groups compared to the normal control, while leucocyte infiltration was observed in the TLE-only group. These results suggest that PNS extract possessed antioxidant activity that alleviated TLE-induced toxicity. Further studies are necessary to understand the pharmacokinetic interactions between ART and PNS.
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Affiliation(s)
- Doreen Enyang
- Medicinal Plant Research and Drug Development Program, Pan African University Life and Earth Sciences Institute, University of Ibadan, Ibadan, Nigeria
| | - Mubo A. Sonibare
- Department of Pharmacognosy, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Armelle D. Tchamgoue
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | - Lauve R. Y. Tchokouaha
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | - Fanta S. Yadang
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | - Gael N. Nfor
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | - Christelle W. Kom
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | - Patrick D. H. Betote
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | - Cedric F. Tchinda
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
| | | | - Gabriel A. Agbor
- Centre for Research on Medicinal Plants and Traditional Medicine, Institute of Medical Research and Medicinal Plants Studies, Ministry of Scientific Research and Innovations, P.O. Box 6163, Yaoundé, Cameroon
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Srinivasan R, Padmapriyadarsini C, Ramesh K, Sanjeeva G, Reddy D, Suresh E, Kumar R, Sathyamoorthy P, Swaminathan S, Shet A. APOC3 Gene Polymorphism and Antiretroviral Therapy-Induced Dyslipidemia in HIV-Infected Children. AIDS Res Hum Retroviruses 2021; 37:92-100. [PMID: 33115242 DOI: 10.1089/aid.2020.0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Children exposed to antiretroviral therapy (ART) are at risk of developing metabolic complications. The association between gene polymorphisms and the development of dyslipidemia in children post ART initiation was studied. Children initiating first-line ART were followed for 2 years at the National Institute for Research in Tuberculosis (Chennai, India), and St. John's Medical College Hospital (Bangalore, India). Clinical examination and fasting serum lipid profiles were measured every 6 months. Participants were genotyped for the polymorphisms in the APOC3 gene (rs2854116; rs2854117, and rs5128). Changes in lipid levels from baseline to months 6, 12, and 24, and the difference between the various genotype variants were analyzed using a modified analysis of variance test. Study enrolled 393 ART-naive HIV-infected children (mean age: 7.6 ± 3 years, mean weight: 18 ± 6) of whom 289 (75%) were started on nevirapine (NVP)-based ART and the remaining 96 (25%) were started on efavirenz-based ART. Only children carrying the GG allele of rs5128 genotype showed a decrease in CD4% and serum triglycerides pre-ART. An increasing trend of total cholesterol, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol were seen at 6 months in both EFZ and NVP groups, which subsequently stabilized by 12 months irrespective of genotype variants. Genotype variants of APOC3 (rs2854116 and rs2854117 polymorphism) did not show significant changes in serum lipid levels after 24 months of ART, whereas rs5128 polymorphism with "G" allele showed an association with HDL-c levels when on NVP-based ART. Our results suggest that ART plays a major role in normalizing lipid levels in HIV-infected children and APOC3 polymorphisms may not play a significant role in ART-induced dyslipidemia.
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Affiliation(s)
| | | | | | - G.N. Sanjeeva
- Indira Gandhi Institute of Child Health, Bangalore, India
| | - Devarajulu Reddy
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Elumalai Suresh
- Institute of Child Health and Children's Hospital, Chennai, India
| | - Ramesh Kumar
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | | | | | - Anita Shet
- St. Johns Research Institute, Bangalore, India
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Obirikorang C, Acheampong E, Quaye L, Yorke J, Amos-Abanyie EK, Akyaw PA, Anto EO, Bani SB, Asamoah EA, Batu EN. Association of single nucleotide polymorphisms with dyslipidemia in antiretroviral exposed HIV patients in a Ghanaian population: A case-control study. PLoS One 2020; 15:e0227779. [PMID: 31929604 PMCID: PMC6957303 DOI: 10.1371/journal.pone.0227779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/28/2019] [Indexed: 01/11/2023] Open
Abstract
Dyslipidemia is a potential complication of long-term usage of antiretroviral therapy (ART) and also known to be associated with genetic factors. The host genetic variants associated with dyslipidemia in HIV patients on ART in Ghana have not been fully explored. The study constituted a total of 289 HIV-infected patients on stable ART for at least a year. Fasting blood was collected into EDTA tube for lipids measurement. Lipid profiles were used to define dyslipidemia based on the NCEP-ATP III criteria. HIV-infected subjects were categorized into two groups; those with dyslipidemia (cases) (n = 90; 31.1%) and without dyslipidemia (controls)(n = 199; 68.9%). Four candidate single nucleotide polymorphism (SNP) genes (ABCA1-rs2066714, LDLR-rs6511720, APOA5-rs662799 and DSCAML1-rs10892151) were determined. Genotyping was performed on isolated genomic DNA of study participants using PCR followed by a multiplex ligation detection reaction (LDR). The percentage of the population who had the rare homozygote alleles for rs6511720 (T/T), rs2066714 (G/G), rs10892151 (T/T) and rs662799 (G/G) among case subjects were 5.5%, 14.4%, 6.6% and 10.0% whiles 2.0% 9.1%, 6.5% and 4.0% were observed among control subjects. There were statistically significant differences in the genotypic prevalence of APOA5 (p = 0.0357) and LDLR polymorphisms (p = 0.0387) between case and control subjects. Compared to the AA genotype of the APOA5 polymorphisms, individuals with the rare homozygote genotype [aOR = 2.38, 95%CI(1.06-6.54), p = 0.004] were significantly associated with an increased likelihood of developing dyslipidemia after controlling for age, gender, treatment duration, CD4 counts and BMI. Moreover, individuals with the rare homozygous genotype of ABCA1 (G/G) [aOR = 10.7(1.3-88.7), p = 0.0280] and LDLR (rs6511720) G>T [aOR = 61.2(7.6-493.4), p<0.0001) were more likely to have high levels of total cholesterol levels. Our data accentuate the presence of SNPs in four candidate genes and their association with dyslipidemia among HIV patients exposed to ART in the Ghanaian population, especially variants in APOA5-rs662799 and LDLR rs6511720 respectively. These findings provide baseline information that necessitates a pre-symptomatic strategy for monitoring dyslipidemia in ART-treated HIV patients. There is a need for longitudinal studies to validate a comprehensive number of SNPs and their associations with dyslipidemia.
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Affiliation(s)
- Christian Obirikorang
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Lawrence Quaye
- School of Allied Health Sciences, University of Development Studies, Tamale, Ghana
| | - Joseph Yorke
- Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Ernestine Kubi Amos-Abanyie
- H3Africa Kidney Disease Research Project, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Priscilla Abena Akyaw
- H3Africa Kidney Disease Research Project, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Enoch Odame Anto
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Simon Bannison Bani
- School of Allied Health Sciences, University of Development Studies, Tamale, Ghana
| | - Evans Adu Asamoah
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Emmanuella Nsenbah Batu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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Padmapriyadarsini C, Ramesh K, Sekar L, Ramachandran G, Reddy D, Narendran G, Sekar S, Chandrasekar C, Anbarasu D, Wanke C, Swaminathan S. Factors affecting high-density lipoprotein cholesterol in HIV-infected patients on nevirapine-based antiretroviral therapy. Indian J Med Res 2018; 145:641-650. [PMID: 28948955 PMCID: PMC5644299 DOI: 10.4103/ijmr.ijmr_1611_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background & objectives: Cardiovascular disease (CVD) risk with low high-density lipoprotein cholesterol (HDL-C) and high triglycerides is common in the general population in India. As nevirapine (NVP)-based antiretroviral therapy (ART) tends to increase HDL-C, gene polymorphisms associated with HDL-C metabolism in HIV-infected adults on stable NVP-based ART were studied. Methods: A cross-sectional study was conducted between January 2013 and July 2014 among adults receiving NVP-based ART for 12-15 months. Blood lipids were estimated and gene polymorphisms in apolipoprotein C3 (APOC3), cholesteryl ester transfer protein (CETP) and lipoprotein lipase (LPL) genes were analyzed by real-time polymerase chain reaction. Framingham's 10-yr CVD risk score was estimated. Logistic regression was done to show factors related to low HDL-C levels. Results: Of the 300 patients included (mean age: 38.6±8.7 yr; mean CD4 count 449±210 cell/μl), total cholesterol (TC) >200 mg/dl was observed in 116 (39%) patients. Thirty nine per cent males and 47 per cent females had HDL-C levels below normal while 32 per cent males and 37 per cent females had TC/HDL ratio of 4.5 and 4.0, respectively. Body mass index [adjusted odds ratio (aOR)=1.70, 95% confidence interval (CI) 1.01-2.84, P=0.04] and viral load (aOR=3.39, 95% CI: 1.52-7.52, P=0.003) were negatively associated with serum HDL-C levels. The 10-yr risk score of developing CVD was 11-20 per cent in 3 per cent patients. Allelic variants of APOC3 showed a trend towards low HDL-C. Interpretation & conclusions: High-risk lipid profiles for atherosclerosis and cardiovascular disease were common among HIV-infected individuals, even after 12 months of NVP-based ART. Targeted interventions to address these factors should be recommended in the national ART programmes.
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Affiliation(s)
- C Padmapriyadarsini
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - K Ramesh
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - L Sekar
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Geetha Ramachandran
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Devaraj Reddy
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - G Narendran
- Department of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - S Sekar
- ART Centre, Rajiv Gandhi Government General Hospital, Chennai, India
| | - C Chandrasekar
- Nodal ART Medical Officer, Government Hospital of Thoracic Medicine, Chennai, India
| | - D Anbarasu
- ART Centre, Government Vellore Medical College & Hospital, Vellore, India
| | - Christine Wanke
- Department of Medicine, Tufts University School of Medicine, Boston, USA
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Ngala RA, Fianko K. Dyslipidaemia and dysglycaemia in HIV-infected patients on highly active anti-retroviral therapy in Kumasi Metropolis. Afr Health Sci 2013; 13:1107-16. [PMID: 24940339 PMCID: PMC4056472 DOI: 10.4314/ahs.v13i4.35] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Diet and genetic predisposition significantly affect lipid metabolism in the individual. This metabolic effect is further challenged in patients infected with HIV and on HAART. The prolonged use of HAART is associated with lipodystrophy, dyslipidemia, and insulin resistance. OBJECTIVE To determine the prevalence of lipid dysregulation and dysglycaemia in HIV infected patients on HAART in the Kumasi metropolis. METHODS This cross sectional study was conducted between October 2009 and June 2010, and 305 HIV-infected patients consisting of 164 patients on HAART for at least six months and 141 HAART-naive patients constituted HIV-positive patients, not on HAART and whose CD4 were not below 320 cell/ml as the control. Data was analyzed using Graph Pad Prism (version 5.0). Unpaired t-test, linear and multivariate regression analyses, was used to predict glucose level from the various parameters. Anthropometric parameters consisting of body weight, waist and hip circumferences, height, bicep and triceps skin fold were measured with a pair of calipers. Lipid profile and fasting blood glucose were determined by enzymatic methods. CD4 counts and hemoglobin were determined. RESULTS Fasting plasma, glucose (3.81±0.08mmol/l, 4.48±0.17mmol/l), total cholesterol (3.05± 0.0 8mmol/l, 4.54±0.08mmol/l) LDL (2.24±0.07mmol/l, 2.87±0.07mmol/l) and HDL (0.85±0.04mmol/l, 0.97±0.03mmol/l) between the control and case respectively were significantly raised (P< 0.001), though within the physiological range. The significantly increased hip and waist circumferences, waist-to-hip ratio (0.85±0.22, 0.88±0.01) of the control and case correlated with lipodystrophy. CONCLUSION HAART was associated with lipodystrohy and, the risk of developing type II diabetes among the HAART experienced group was 5 times higher than the HAART naive group.
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Affiliation(s)
- R A Ngala
- Department of Molecular Medicine, Kwame Nkrumah University of Science &Technology
| | - K Fianko
- Department of Biochemistry, Ghana Health Service
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de Almeida ERD, Reiche EMV, Kallaur AP, Flauzino T, Watanabe MAE. The roles of genetic polymorphisms and human immunodeficiency virus infection in lipid metabolism. BIOMED RESEARCH INTERNATIONAL 2013; 2013:836790. [PMID: 24319689 PMCID: PMC3844249 DOI: 10.1155/2013/836790] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 09/02/2013] [Accepted: 09/11/2013] [Indexed: 12/31/2022]
Abstract
Dyslipidemia has been frequently observed among individuals infected with human immunodeficiency virus type 1 (HIV-1), and factors related to HIV-1, the host, and antiretroviral therapy (ART) are involved in this phenomenon. This study reviews the roles of genetic polymorphisms, HIV-1 infection, and highly active antiretroviral therapy (HAART) in lipid metabolism. Lipid abnormalities can vary according to the HAART regimen, such as those with protease inhibitors (PIs). However, genetic factors may also be involved in dyslipidemia because not all patients receiving the same HAART regimen and with comparable demographic, virological, and immunological characteristics develop variations in the lipid profile. Polymorphisms in a large number of genes are involved in the synthesis of structural proteins, and enzymes related to lipid metabolism account for variations in the lipid profile of each individual. As some genetic polymorphisms may cause dyslipidemia, these allele variants should be investigated in HIV-1-infected patients to identify individuals with an increased risk of developing dyslipidemia during treatment with HAART, particularly during therapy with PIs. This knowledge may guide individualized treatment decisions and lead to the development of new therapeutic targets for the treatment of dyslipidemia in these patients.
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Affiliation(s)
- Elaine Regina Delicato de Almeida
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Avenida Robert Koch, 60, CEP 86038-440 Londrina, PR, Brazil
- Pathological Sciences Postgraduate Program, Biological Sciences Center, State University of Londrina, Campus Universitário, CEP 86051-970 Londrina, PR, Brazil
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Avenida Robert Koch, 60, CEP 86038-440 Londrina, PR, Brazil
| | - Ana Paula Kallaur
- Postgraduate Program of Health Sciences Center, State University of Londrina, Avenida Robert Koch, 60, CEP 86038-440 Londrina, PR, Brazil
| | - Tamires Flauzino
- Clinical Immunology, Clinical Analysis Laboratory, Health Sciences Center, State University of Londrina, Avenida Robert Koch, 60, CEP 86038-440 Londrina, PR, Brazil
| | - Maria Angelica Ehara Watanabe
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Campus Universitário, CEP 86051-970 Londrina, PR, Brazil
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