Abstract

Heme formation can be described and understood via various pathways. Herein, a foundation of heme formation will be characterized by four distinct, but interconnected, tracts: locations of heme formation, pathways of heme formation, functions of heme, and disorders in heme formation. This paper reviews the healthy state of mitochondria and the cell (and thus, normal heme formation and function) in unperturbed states and correlates disruptions in one or more of the four tracts mentioned above regarding heme in disease, in particular, HIV. This investigation (on a basic, fundamental, and condensed level) lays the groundwork for assessing certain conditions (and risk factors thereof) from a cellular level by connecting defects in heme formation and mitochondrial aberrations with complementary therapies for the prevention and treatment of HIV. This economical complementary addition to HIV prevention and treatment could prove valuable globally and especially to countries with limited resources.

Keywords: Anemia; Delta-aminolevulinic acid; Cytochrome P450; Enzyme defect; Heme; HIV; Krebs cycle; Mitochondria; Porphyria; Prosthetic groups; Protoporphyrinogen; RBC

Abbreviations: ALA: Aminolevulinic Acid; ΔALAS2: Delta-Aminolevulinate Synthase 2; CAC: Citric Acid Cycle; ΔALA: Delta-Aminolevulinic Acid; HIV: Human Immunodeficiency Virus; MRC: Mitochondrial Respiratory Chain; PBMC: Peripheral Blood Mononuclear Cell; PCG-1a: Peroxisome Proliferator- Activated Receptor Gamma Coactivator; RBC: Red Blood Cell