HIV and AIDS Introduction

The primary cause of AIDS is infection with the human immunodeficiency virus (HIV). People infected with HIV range from those that may have a positive test for HIV but exhibit no symptoms for many years (asymptomatic), to individuals who have a late stage HIV infection. Those in the later stages of infection have progressive HIV coupled with an AIDS-defining illness, such as, Pneumocystis carinii pneumonia or Kaposi’s sarcoma.

HIV is a viral infection that infects CD4 lymphocytes, a type of white blood cell responsible for coordinating the functions of the immune system to fight infection. HIV reproduces rapidly in the infected cells and destroys them. If the HIV infection is left untreated, the number of CD4 lymphocytes begins to fall, causing eventual destruction of the immune system. Diagnosis of AIDS can be made with a positive HIV test and a CD4 count of less than 200 cells per microliter of blood (individual cases may vary). HIV is not contagious and cannot be transmitted by ordinary human contact. HIV is carried in body fluids including; blood, semen, vaginal secretions, salvia and breast milk. It is most commonly transmitted by sexual interaction, sharing or reusing needles contaminated with the virus, infected mother to fetus, and from organ transplants or blood transfusions. Organs, tissues, and blood donors are now routinely screened for HIV.

According to the Centers for Disease Control (CDC):

• During 2002, the cumulative number of AIDS cases reported to CDC is 886,000.

• During 2002, an estimated 38 million people are believed to be infected with HIV world-wide.

• During 2003, an estimated 5 million people acquired AIDS, the greatest number in any one year since the beginning of the epidemic.

• During 2003, total deaths of individuals reported with AIDS are almost three million. Over 20 million have died since the first cases of AIDS were identified in 1981.

The onset of AIDS following HIV infection varies anywhere between 1 and more than 14 years. Acute HIV symptoms commonly appear within 6 weeks of infection. Persons may first experience flu-like symptoms and other signs of infection, including:

• Swollen lymph glands
• Fever
• Fatigue
• Night sweats
• Rash on the trunk
• Diarrhea
• Joint and muscle pain
• Sore throat

Symptoms may last from several days up to two weeks. After this active phase, an HIV-infected individual may remain free of symptoms for years. However, the virus may continue to reproduce and further depress the immune system. This may lead to the onset of AIDS. AIDS-defining illnesses can develop. These illnesses can include such opportunistic infections as Pneumocystis carinii pneumonia, cancers (Kaposi’s sarcoma), and certain neurological changes, including dementia and loss of nerve function..

Although there is no vaccine or cure for AIDS, combinations of antiretroviral drugs effectively prevent HIV from replicating. By suppressing the viral infection, these drugs also slow the progression of HIV infection to AIDS. The three groups of drugs that are used to treat HIV are; protease inhibitors, nucleoside reverse transcriptase inhibitors, and non-nucleoside reverse transcriptase inhibitors. These drugs assist in the blockage of the enzymes used in viral replication and propagation.

Multivitamin Nutrient deficiency (including vitamin and mineral deficiency) and malnourishment is common in AIDS and HIV-positive patients. This absence further weakens immune function and may contribute to the progression from HIV to AIDS.[1] A good, high potency multivitamin/mineral supplement helps the immune system to function optimally in HIV/AIDS individuals.

Vitamin E Vitamin E is a potent antioxidant that has been shown to slow down the progression of HIV to AIDS.[2] One study has revealed a thirty-four percent decrease in the progression of AIDS in patients with the highest levels of vitamin E in their blood, compared with those patients with the lowest levels.[3] Supplementation with vitamin E helps maximize the nutritional status and immune function of HIV/AIDS patients.

Vitamin A and Beta-Carotene HIV-positive individuals often have vitamin A and beta-carotene deficiencies, which significantly impairs T cells and immunity. Beta-carotene, which the body converts into vitamin A, may be the preferred form of vitamin A supplementation in HIV patients, due to the possibility that retinoic acid, an active form of vitamin A, may increase HIV replication. Studies indicate that beta-carotene supplementation has improved T cell function.[4] However, if high-dose beta-carotene is used over a long period of time it may cause liver enzyme elevation. Therefore, it is not recommended for AIDS patients who also have hepatitis or liver damage.

Vitamin C In Vitro research of Vitamin C has shown its promise in preventing HIV replication. One particular study showed that vitamin C supplementation slowed the progression of AIDS in HIV-positive individuals.[5] Opposing studies, however, have found that high-doses of vitamin C (greater than 1,000 mg three times per day) may suppress T-cell function. For this reason, it is universally recommended that lower doses of vitamin C (500 to 1,000 mg three times per day) be administered in persons suffering from both conditions.[6]

CoEnzyme Q10 (COQ10) Coenzyme Q10 (CoQ10) is a potent antioxidant produced in the body that is often deficient in HIV-positive individuals. Studies have found that CoQ10 supplementation improved T cell function and has provided other health benefits in AIDS patients.[7]

Selenium AIDS and HIV-positive patients have significant deficiencies of selenium-dependent glutathione peroxidase (GSH-PX), an important antioxidant enzyme. Lower levels of glutathione and selenium can contribute to the progression of AIDS. Selenium supplementation has been shown to improve immune function and increase GSH-PX activity in HIV-positive patients.[8]

Lipoic Acid Studies suggest that lipoic acid has antioxidant effects which may prevent the replication of the human immunodeficiency virus.[9] Lipoic acid supplementation has also been shown to increase plasma antioxidant levels in the blood.[10] Supplementation with lipoic acid may help in maximizing the immune system function of HIV/AIDS patients.

Vitamin B-12 Studies have shown that many patients with AIDS experience vitamin B12 deficiency as a result of malabsorption syndrome or antagonism to the drug AZT.[11] This may contribute to the progression of AIDS because vitamin B12 has been shown to prevent HIV replication in vitro.[12] Supplementation with vitamin B12 helps to maximize the nutritional status and immune function of HIV/AIDS patients.

Carnitine AIDS patients often experience a carnitine deficiency in blood cells.[13] This may contribute to the progression of AIDS. The dietary supplementation of carnitine has been shown to improve white blood cells function, reduce HIV-induced immune suppression, and prevent the toxicity of the drug AZT on muscle cells.[14] Supplementation with carnitine also helps to maximize the immune function of HIV/AIDS patients.

Essential Fatty Acids (Fish Oil and Flaxseed Oil) HIV/AIDS individuals often have EPA and DHA essential fatty acid deficiencies, which impairs immunity.[15] Supplementation with omega-3 and omega-6 fatty acids, like fish and flaxseed oils, helps to maximize the nutritional status and immune function of HIV/AIDS patients.

Dehydroepiandrosterone (DHEA) DHEA is a natural steroid hormone produced by the adrenal glands and helps to maintain healthy functioning of the immune system. According to studies, DHEA levels decline as patients progress from being HIV positive to having AIDS.[16] DHEA is contraindicated in both men and women with hormone-related cancers. DHEA supplementation should be monitored with supervision of a physician.

Licorice (Glycyrrhiza Galbra) Glycyrrhizin (licorice root’s active component) supplementation has been shown to improve immune function in HIV-positive and AIDS patients.[17] However, if glycyrrhizin is used over a long period of time, it may cause high blood pressure. Blood pressure monitoring and dietary potassium intake is recommended when licorice is used as a dietary supplement.

Olive Leaf Extract Olive leaf extract contains a phenolic glucoside, known as oleuropein, which has been shown to have powerful antioxidant and antimicrobial properties.[18] Olive leaf has been shown to exhibit strong antiviral (including HIV virus), antibacterial, antifungal, and antiparasitic properties. It may also be a legitimate compound for the natural treatment of certain infections, skin diseases, arthritis, and cardiovascular disease.

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[20] A. Baur et al., “Alpha-Lipoic Acid Is an Effective Inhibitor of Human Immuno-Deficiency Virus (HIV-1) Replication,” Klin Wochenschr 69 (1991): 722-4.

[21] Y.J. Suzuki, et al. “Alpha-Lipoic Acid Is a Potent Inhibitor of NF-kB Activation in Human T Cells,” Biochem Biophys Res Commun 189 (1992): 1709-15.

[22] J. Fuchs et al., “Studies on Lipoate Effects on Blood Redox State in Human Immunodeficiency Virus Infected Patients,” Arzneim Forsch 43 (1993): 1359-62.

[23] KR Robertson et al., “Vitamin B12 Deficiency and Nervous System Disease in HIV Infection,” Arch Neurol 50 (1993): 807-11.

[24] O. Palteil et al., “Clinical Correlates of Subnormal Vitamin B12 Levels in Patients Infected with the Human Immnodeficiency Virus,” Am J Hematol 49 (1995): 318-22.

[25] SAJ Rule, “Serum Vitamin B12 and transcobalamin Levels in Early HIV Disease, " Am J Hematol 47 (1994): 167-71.

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[29] De Simone et al., “High Dose L-Carnitine Improves Immunologic and Metabolic Parameters in AIDS Patients,” Immunopharmacol Immunotoxicol 15 (1993): 1-12.

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[35] Mulder JW, Frissen PH, Krijnen P, et al. Dehydroepiandrosterone as predictor for progression to AIDS in asymptomatic human immunodeficiency virus-infected men. J Infect Dis. 165(3) (1992):413-8.

[36] T. Hattori et al. “Preliminary Evidence for Inhibitory Effect of Glycyrrhizin on HIV Replication in Patients with AIDS,” Antiviral Res 11 (1989): 255-61.

[37] K. Mori et al. “Effects of Glycyrrhizin (SNMC: Stronger Neo-Minophagen C) in Hemophilia Patients with HIV-1 Infection,” (Tohoku J Exp Med 162 (1990): 183-93.

[38] Bisignano G, et al. “On the in-vitro antirmicrobial activity of oleuropein and hydroxytyrosol. J Pharm Pharmacol. 51 (6) (1999): 971-4

[39] Visioli F, et al. Oleuropein, the bitter principle of olives, enhances nitric oxide production by mouse macrophages. Life Sci 62 (6) (1998): 541-6.

[40] CDC annual HIV/AIDS Surveillance Report, “Cumulative AIDS cases”, http://www.cdc.gov/hiv/stats.htm