What You Have Learned So Far
Diagnosing and Monitoring HIV/AIDS
Treatment: A Drug Cocktail
- They have a history of opportunistic infections and severe symptoms of HIV infection regardless of T-cell counts.
- They have a T-cell count of less than 200 cells/µL, whether or not symptoms are present. Additionally, antiretroviral therapy may be offered to asymptomatic patients who have a T-cell count of from 201 to 350 cells/µL.
- Nucleoside reverse transcriptase inhibitors (NRTIs)—These drugs interfere with HIV’s ability to be imported into the DNA of healthy immune cells. Examples: abacavir, emtricitabine, lamivudine, stavudine, tenofovir, zalcitabine, zidovudine.
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)—These drugs (like NRTIs) also bind to a specific part of HIV and inhibit its growth. Examples: delavirdine, efavirenz, nevirapine.
- Protease inhibitors—These drugs inhibit protease, an enzyme that is used to help assemble HIV after it has been incorporated into host DNA. Examples: amprenavir, atazanavir, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir.
Antioxidants: Protecting Yourself
- Alpha-lipoic acid—This powerful antioxidant plays a central role in defense against free radicals (Pande V et al 2003; Suzuki YJ et al 1992). Moreover, alpha-lipoic acid has the remarkable ability to recycle several other important antioxidants, including vitamins C and E, glutathione, coenzyme Q10 (CoQ10), as well as itself. Alpha-lipoic acid can boost the level of intracellular glutathione, and may directly inhibit HIV-1 replication (Baur A et al 1991).
- Beta-carotene—Beta-carotene has been shown to stimulate the immune systems of patients with HIV/AIDS (Coodley GO et al 1993). In people infected with HIV who were given 100,000 international units (IU) of vitamin A from beta-carotene daily for 4 weeks, white blood cell counts rose by 66 percent, but T-helper cells rose only slightly. Six weeks after beta-carotene treatment was discontinued, the immune-cell measurements returned to pretreatment levels (Fryburg DA et al 1995).
- Green tea—Green tea leaves contain catechins with powerful antioxidant properties. The most abundant catechin found in green tea, epigallocatechin gallate (EGCG), inhibits HIV from infecting human T-cells. One recent study showed that EGCG can bind to T-cells and block the virus from attaching (Kawai K et al 2003). This breakthrough may significantly impact HIV research if future investigators can determine the precise location on the T-cells in which EGCG exerts its effect and whether it is the same location in which HIV binds to the T-cell.
- Selenium—Selenium is required for proper functioning of the immune system (Look MP et al 1997). It is also essential in the synthesis of glutathione. Selenium’s many benefits include protecting the central nervous system from dementia caused by HIV (Shor-Posner G et al 2002a) and infection with Mycobacterium tuberculosis (Shor-Posner G et al 2002b); slowing the loss of T-cells (Look MP et al 1997); and decreasing the effect of inflammatory cytokines, which may reduce the risk of developing neurological damage (Bjugstad KB et al 1998; Ryan LA et al 2001; Seilhean D et al 1997), Kaposi's sarcoma (a common HIV-associated cancer), and wasting syndrome. Selenium also suppresses the enhancing effect of cytokines on HIV replication (Hori K et al 1997; Tolando R et al 2000).
- Vitamin C and N-acetylcysteine—Vitamin C (ascorbic acid) and N-acetylcysteine (Renis HE 1975) have multiple benefits in patients with HIV/AIDS. They maintain glutathione levels (Fawzi WW et al 2004; McComsey G et al 2003), improve T-cell counts and reduce viral load in patients who have advanced AIDS (McComsey G et al 2003; Standish LJ et al 2001; Tantcheva LP et al 2003), and have a toxic effect on HIV-infected cells (high levels of vitamin C) (Harakeh S et al 1991; Rivas CI et al 1997). Supplementation with N-acetylcysteine is recommended for people who are infected with HIV, whether or not they are receiving HAART.
- Whey—Whey protein contains all essential and nonessential amino acids, which are important to maintaining an adequate immune system response. Whey is also an important supplement to help boost the body’s synthesis of glutathione, and clinical trials have successfully used whey protein in treating HIV (Marshall K 2004). Whey protein appears to be unique among proteins in its ability to improve immune function, elevate cellular glutathione levels, and maintain muscle mass (Marshall K 2004; Micke P et al 2002).
Boosting the Immune System
- CoQ10—People infected with HIV are often deficient in this important substance. CoQ10 is found in high concentrations in the healthy heart, where it improves cardiac function. CoQ10 also increases a number of immune parameters, including T-cell counts (Folkers K et al 1991; Yamashita S et al 1997).
- L-carnitine. Also recommended as an antioxidant, L-carnitine boosts immune function to protect the heart against zidovudine toxicity (Mutomba MC et al 2000). L-carnitine can also protect against an increased level in triglycerides that is associated with protease inhibitors. High doses of L-carnitine enhance immunological and metabolic functions (Evangeliou A et al 2003). L-carnitine helps preserve T-cells by inhibiting cell death (Cifone MG et al 1997).
- L-glutamine. In addition to its important role as an antioxidant, the amino acid L-glutamine plays a major role in the overall health of the gastrointestinal tract. Cells in the gastrointestinal tract have high energy requirements; glutamine is converted into adenosine triphosphate, which is a primary energy source (Alverdy JC 1990; Newsholme EA et al 1985; Souba WW et al 1985). Supplementation of antioxidants and glutamine increases body weight and cell mass. Thus, it provides a highly cost-effective therapy for the rehabilitation of patients infected with HIV who are losing weight (Shabert JK et al 1999).
- Vitamin B12. Studies have shown that patients with AIDS have a vitamin B12 deficiency as a result of severe nutrient malabsorption (Ehrenpreis ED et al 1994; Remacha AF et al 1991). Vitamin B12 deficiency is associated with reduced red blood cell count, depression, memory loss, insomnia, impotence, and lowered energy. If supplementation does help restore normal levels of vitamin B12, weekly injections may be indicated (Rule SA et al 1994).
- Zinc and magnesium. On average, patients with HIV/AIDS who have low zinc levels have a higher viral load and lower T-cell counts (Ferencik M et al 2003; Rousseau MC et al 2000). While on HAART, the conditions of patients with HIV should be monitored for zinc deficiencies, and supplements recommended when necessary (Wellinghausen N et al 2000). Additionally, low magnesium levels are related to HIV symptoms and disease progression (Patrick L 2000 Feb; Skurnick JH et al 1996).
Wasting and Metabolic Syndromes: The Scourges of AIDS
One of the most dreaded aspects of HIV/AIDS infection occurs near the end of the infection cycle. Known as wasting syndrome, it is defined as the involuntary loss of more than 10 percent of body weight. The weight loss is accompanied by chronic diarrhea, weakness, and fever (Salomon J et al 2002).
The major cause of the weight loss is malnutrition, which emphasizes the need for adequate nutrition in patients with HIV/AIDS. A comprehensive and diversified nutritional regimen is critical in order to obtain optimal benefit from the moment HIV is diagnosed.
Maintaining adequate nutrition is easier in the earlier stages of infection. Opportunistic infections may make it harder to absorb the proper amount of calories and maintain nutritional health. Low levels of antioxidants and micronutrients in patients with HIV/AIDS are often related to low nutrient intake, as well as to malabsorption resulting from diarrhea and metabolic problems (Butensky EA 2001; Chariot P et al 2003).
Fighting the Virus: Natural Approaches
Olive leaf extract
Licorice root extract
Milk thistle extract
Restoring Hormone Balance
Low serum levels of dehydroepiandrosterone (DHEA)
- The benefits of thymosin alpha-1 are due mostly to its ability to enhance T-cell function. Studies have shown the following benefits:
- Increased activity from natural killer (NK) immune cells (Favalli C et al 1989; Roch-Arveiller M et al 1991; Serrate SA et al 1987).
- Enhanced production of T-cells in patients with chronic hepatitis B (Mutchnick MG et al 1991) and cancer (Salvati F et al 1996).
- Decreased replication of HIV-1 in human blood cells (Moody TW et al 1993).
- Thymosin alpha-1 is currently being considered for phase 3 clinical trials in the treatment of hepatitis. It is not yet approved in the United States, but has been approved for various uses in more than 30 countries.
Living With HIV/AIDS
Dietary supplementation in HIV/AIDS is an important part of the overall strategy.
With any program of dietary supplementation in patients with HIV/AIDS, it is important that no supplement or nutrient is added to the diet without the approval of the patient’s physician. Fortunately, more physicians are beginning to understand the value of robust nutritional supplementation for patients with HIV/AIDS. The Life Extension Foundation suggests:
HIV/AIDS Safety Caveats
An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:
Vitamin B12 (cyanocobalamin)
For more information see the Safety Appendix