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Acquired Immune Deficiency Syndrome (AIDS)

Introduction

What should I know about AIDS?

First recognized as a disease in 1981, AIDS now ranks high among the world’s most urgent public health problems. AIDS is currently the fifth leading cause of death among adults between the ages of 25 and 44. (1) "Acquired Immune Deficiency Syndrome" is a severe depletion of the immune system that seriously weakens the body’s defenses against infection. Death due to AIDS is not caused by the immune deficiency itself, but by infectious organisms that take advantage of the ravaged immune system. A normal, healthy immune system is fully able to fend off most of the diseases that kill people with AIDS.

Although infection by the HIV virus is the accepted cause of AIDS, HIV infection and AIDS are not one and the same. Just because someone tests "HIV positive," indicating their blood contains antibodies to the HIV virus, does not mean they have AIDS. People may not show symptoms of AIDS for many years following initial infection by HIV.

The HIV virus is transmitted from person to person by direct contact with blood or body fluids such as lymph, semen, and vaginal secretions. Intimate sexual activity is the most common route of exposure to the virus. HIV is not spread through kissing or household contact such as sharing a drinking glass with an infected family member. Needle sharing among IV drug users is a major route of transmission. Pregnant women infected with HIV can pass the virus to their unborn babies. Exposure to infected blood or blood products in the health care setting is another possible means of infection, although this accounts for a very small number of AIDS cases.

Once it invades the body, the HIV virus enters the "T4 helper cells," white blood cells that coordinate the various cellular functions of the immune system. The virus then penetrates the T4 cell nucleus and commandeers the cell’s DNA, instructing it to make copies of the virus. In effect, HIV turns the T4 cells into virus-making factories. Eventually these cells are destroyed, leaving the immune system crippled. The HIV infected person now has AIDS.

In order to be diagnosed with AIDS, an HIV positive individual must have either: 1) Less than 200 T4 cells per cubic millimeter of blood (In a healthy person the T4 count ranges from 650 to 1200), or 2) One of a list of additional clinical conditions that includes: candidiasis, invasive cervical cancer, CMV virus disease, histoplasmosis, mycobacterium infection, recurrent pneumonia, salmonella bacteria infection, and wasting syndrome due to HIV. People with AIDS may also be inflicted with a rare form of cancer called Kaposi’s sarcoma.

Statistic

World Health Organization, December 2006.
  • An estimated 39.5 million people are living with HIV.  
  • Important increases in Eastern Europe and Central Asia, where there are some indications that infection rates have risen by more than 50% since 2004.
  • In 2006, 2.9 million people died of AIDS-related illnesses.
  • More than 25 million people have died of AIDS since 1981.
  • Young people (under 25 years old) account for half of all new HIV infections worldwide – around 6,000 become infected with HIV every day.
  • There were 4.3 million new infections in 2006.
World Health Organization, December 2006. Sub-Saharan Africa
  • 2.8 million (65%) of new infections occurred in sub-Saharan Africa.
  • 2.1 million AIDS deaths in sub-Saharan Africa represent 72% of global AIDS deaths.
  • Africa has 12 million AIDS orphans.
  • South Africa remains the epicenter of the global HIV epidemic: 32% of people with HIV globally live in this subregion and 34% of AIDS deaths globally occur there.
Malaysian Aids Foundation, 2005.
  • 60,621 people have reported HIV-positive since the first case in 1986.
  • 2,609 new cases were reported in 2004; an average of 14.7 new infections each day.
  • More than 32% of reported HIV cases are men and women between the ages of 20 and 39 years old.
  • 6,523 people have died of AIDS in Malaysia.
Sustainable Development Networking Programme (SDNP), 2004.
  • Estimates show 8.2 million people are living with HIV.
  • 2.3 million adult women are living with HIV at the end of 2004.
  • 1.2 million newly infected people.
  • AIDS claimed 540,000 lives in 2004.
  • Among young people 15–24 years of age, 0.3% of women and 0.4% of men were living with HIV by the end of 2004.
Barbados, Department Of Defense HIV/AIDS Prevention Program, 2005.
  • The HIV/AIDS prevalence rate in the general population is estimated to be 1.5%, with approximately 2,500 people living with HIV/AIDS.
  • HIV prevalence in men exceeds that in women by almost 3:1.
India, UNAIDS/World Health Organization, 2006.
  • Approximately 5.7 million people are living with HIV/AIDS in India.
  • 5.6 million were adults aged 15-49 years.
Kenya, UNAIDS/World Health Organization, 2006.
  • Approximately 1,300,000 people are living with HIV in Kenya.
  • 740,000 are women
  • 150,000 are children
  • 140,000 deaths due to AIDS.
  • 1,100,000 orphans due to AIDS.

New Zealand Aids Foundation, 2006.
  • 183 people were newly diagnosed with HIV in 2005, a 17% rise from 2004.
Singapore, Ministry of Health, June 2006.
  • Total number of HIV infected Singaporeans are 2852 as of the end of June 2006.
  • Majority of HIV infected Singaporeans are male with 2533 cases.
Nigeria, UNAIDS/World Health Organization, 2006.
  • An estimated 2,900,000 people are living with HIV/AIDS in Nigeria.
  • 220,000 deaths from AIDS.
  • 930,000 AIDS orphans living in Nigeria.
  • 90% of HIV positive children contract the virus from their mothers.
Sri Lanka, UNAIDS/World Health Organization, 2006.
  • 5,000 people are living with HIV/AIDS in Sri Lanka.
  • 1,000 women are living with HIV/AIDS.
  • An estimated 500 deaths were due to AIDS during 2005.

Centers for Disease Control, 2004.

    The cumulative number of AIDS cases reported to CDC is 944,305. Adult and adolescent AIDS cases total 934,862 with 756,399 cases in males and 178,463 cases in females. Through the same time period, 9,443 AIDS cases were reported in children under age 13. Total deaths of persons reported with AIDS through 2004 are 529,113, including 523,598 adults and adolescents, and 5,515 children under age 13.

Joint United Nations Programme on HIV/AIDS, 2002.

    Today, 42 million people are estimated to be living with HIV/AIDS. Of these, 38.6 million are adults. 19.2 million are women, and 3.2 million are children under 15. An estimated 5 million people acquired the human immunodeficiency virus (HIV) in 2002, including 2 million women and 800,000 children under 15. During 2002, AIDS caused the deaths of an estimated 3.1 million people, including 1.2 million women and 610,000 children under 15. Women are becoming increasingly affected by HIV. Approximately 50%, or 19.2 million, of the 38.6 million adults living with HIV or AIDS worldwide are women.

Signs and Symptoms

The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.

In the early stages of HIV infection, as virus levels increase within the body, the infected individual may begin to experience symptoms of infection. Within the first 12 weeks of HIV infection, the patient may develop nonspecific symptoms that are similar to mononucleosis. These may include:

  • Fever
  • Fatigue
  • Swollen lymph nodes
  • Rash
  • Headache
  • Joint and muscle aches
  • Nausea, vomiting, diarrhea
  • Night sweats
Symptoms last from several days up to two weeks, but then improve. After the active phase, virus levels in the body may begin to fall and the patient may enter a latency period, during which the individual is symptom-free. Although patients generally feel better during the latency phase, the infection process continues with the eventual destruction of the patient’s immune system.

A person infected with HIV may remain free of symptoms and in relatively good health for many years. Nonetheless, the virus continues to reproduce and depress the immune system. Eventually, individuals become vulnerable to infections that healthy individuals can fight off. These infections eventually lead to death. At this time, there is no vaccine or cure for AIDS.

Treatment Options

Conventional

There is no cure for AIDS, but advances in drug therapy have made it a treatable disease that can be managed, perhaps indefinitely. The goal is to keep the number of viruses in the body low enough to delay destruction of the immune system as long as possible. The typical drug treatment regimen uses a "cocktail" of several drugs that attack the virus from different angles.

One group of AIDS drugs works by inhibiting an enzyme called "reverse transcriptase," which the HIV virus uses to take over the infected T cell. Two types of reverse transcriptase inhibitors are currently in use; one hits the virus before it binds to the cell’s DNA, while the second stops the virus from programming that DNA to produce more viruses.

"Protease inhibitors" are another widely used class of anti-HIV drugs. These block protease, an enzyme that assembles new viruses inside the infected cell. One way to visualize this is to imagine that reverse transriptase inhibitors tear up the blueprint for making new viruses while the protease inhibitors disable the machinery that makes them. The FDA has approved 14 of these drugs for AIDS treatment.

Anti-HIV drug cocktails successfully suppress replication of the virus and reduce the total number of viruses, called the "viral load," often dramatically. But they do not eliminate it entirely; so far, medical science has not discovered a way to completely eradicate the virus. Only this will be the final cure for AIDS.

One drawback in using anti-viral drugs to treat HIV is that the virus often becomes resistant to the drugs. This means that a particular drug "recipe" only works for a period of time. Once the virus achieves drug resistance it begins to multiply in greater numbers, and the gained ground is lost. Another cocktail must then be prescribed. Newer, more powerful combinations are being researched, and that show an even greater ability to subdue the HIV virus and stabilize the immune system.

Patients in the late stages of AIDS are often on complex multiple drug regimens. Along with antiviral therapy, they must be treated for any secondary infections that may be present. The AIDS sufferer may be taking a host of drugs, including anti-virals, antibiotics, antidepressants, pain medications, and others. Nutritional support is necessary, as people with full-blown AIDS can be dangerously prone to malnutrition.

Nutritional Suplementation


Multivitamin

Malnutrition in AIDS and HIV-positive people can cause additional health problems and further weaken the immune system. Anywhere from 50 to 90% of AIDS patients are malnourished. (2) Nutritional deficiency in AIDS is serious and often contributes to death by further weakening the immune system and reducing the chances of successful treatment. A well-designed nutritional program is an essential part of the overall treatment plan, both for asymptomatic HIV infected individuals and those with full blown AIDS. A comprehensive high potency multivitamin/mineral supplement is vitally important, as AIDS sufferers are prone to vitamin and mineral deficiency.


Vitamin A

Compared to healthy people, HIV-positive individuals and those with AIDS excrete substantially more vitamin A in the urine. Low vitamin A levels have also been shown to increase mother-to-child transmission of HIV during pregnancy. (3)


Vitamin B12

HIV infected people often show low blood levels of vitamin B12. They frequently have problems with digestion and absorption, which can lead to deficiencies of vitamin B12 and other nutrients. In general, vitamin B12 levels tend to decline as the disease progresses. Supplementation may be necessary to prevent conditions that result from severe B12 deficiency such as anemia and neurological symptoms. (4) One study has found a link between B12 deficiency and lowered T4 cell counts in AIDS, suggesting that B12 deficiency may accelerate progression of the disease. (5)


Vitamin C

Ascorbic acid is a crucial nutrient for people with HIV and AIDS, given its importance to the immune system. Vitamin C helps suppress replication of the HIV virus, and it appears to protect the brain from the toxicity that occurs in late stage of AIDS. There is evidence that vitamin C deficiency may contribute to AIDS-related dementia by leaving brain cells vulnerable to damaging byproducts of oxygen metabolism called "free radicals." (6)

Robert Cathcart, M.D. is world famous for his mega-dose vitamin C therapy for AIDS. Cathcart has achieved clinical remission of AIDS symptoms using high doses of ascorbic acid. According to Cathcart, "Preliminary clinical evidence is that massive doses of ascorbate can suppress the symptoms of the disease and can markedly reduce the tendency for secondary infections. In combination with usual treatments for the secondary infections, large doses of ascorbate will often produce a clinical remission which shows every evidence of being prolonged if treatment is continued." Cathcart’s patients have taken as much as 50 to 200 grams of vitamin C every 24 hours. (7)


Vitamin E

Vitamin E is an antioxidant vitamin that may slow down progression of AIDS. One study found that people with HIV and AIDS have lower than normal vitamin E levels. AIDS patients, based on this research, may excrete more vitamin E in their urine as well. Researchers suggest that vitamin E supplementation should be integrated into the existing medical therapy so that patients can maintain proper vitamin E levels. (8)

There are signs that vitamin E helps anti-HIV such as AZT drugs work more effectively. Vitamin E may stimulate immune cells that are normally destroyed by the HIV infection. (9)


Selenium

Selenium is one of the most common nutrient deficiencies among AIDS and HIV-infected individuals. Selenium is an essential trace mineral that plays a key role in the body’s defenses against free radicals. The immune system requires selenium to function properly. Selenium levels are highly correlated with AIDS-related death. Also, the HIV virus utilizes selenium for some of its metabolic purposes, further draining the body’s selenium supply. Selenium supplementation improves immune function and reduces lipid peroxides--free radicals that are particularly damaging to cells. (10) AIDS and HIV-positive patients have shown significant impairments of their selenium-dependent antioxidant defenses. (11)


Zinc

Zinc is one of most important nutrients for immune function. Zinc deficiency weakens the immune system and increases susceptibility to infection. Many AIDS patients are zinc deficient. In studies, zinc supplementation stabilizes body weight, raises T4 cell counts, and reduces the frequency of opportunistic infections. (12) AZT and other similar AIDS drugs deplete zinc from the body, so people on these medications are well-advised to take a zinc supplement every day. (13)


Beta-Carotene

Beta-carotene is sometimes called "vegetarian vitamin A," because the body can convert it into vitamin A as needed. Beta carotene deficiency is common at all stages of HIV/AIDS in both adults (14) and children. (15) In both human and animal studies, vitamin A and beta-carotene have improved T4 cell function and increased T 4 counts. (16)


L-Carnitine

AIDS patients may be deficient in this vitally important amino acid. (17) Studies suggest carnitine supplements might improve immune function. (18)


Coenzyme Q10 (CO-Q10)

This versatile vitamin-like nutrient has many benefits for the immune system. CoQ10 is one of the body’s most needed antioxidants. Not surprisingly, AIDS patients have been found short of coenzyme Q10. What’s more, the CoQ10 deficiency worsens as the disease becomes more severe. In one small trial, 7 patients with AIDS or ARC were treated with coenzyme Q10. Five of the 7 had good symptomatic improvement with no opportunistic infections over a 4 to 7 month period. The researchers themselves felt these results were quite remarkable, especially since some of the patients were less than religious about taking their CoQ10 supplements. (19)


Omega-3, Omega-6

Some researchers see a connection between AIDS and deficiencies of two essential fatty acids called "EPA" and "DHA." These key nutrients may help battle the HIV virus by breaking down its outer membrane coating. (20)

One test-tube study showing destruction of the virus coat by fatty acids also uncovered evidence that fatty acids support the immune system. AIDS patients have been found seriously deficient in EPA and DHA. Essential fatty acid supplements such as fish oil and flaxseed oil are a good addition to the therapeutic nutrition plan HIV and AIDS. (21)


Dehydroepiandrosterone (DHEA)

DHEA is a natural steroid hormone produced by the adrenal glands. DHEA supplements have become popular in recent years as a means of boosting health and vitality. Researchers are now exploring the use of DHEA in AIDS. The use of DHEA for the treatment of AIDS is just beginning to be evaluated. A connection has been found between low DHEA levels in the body and poor immune function. (22)

One study looked at the relationship between DHEA levels and various indicators of HIV progression. The results showed that DHEA levels go down as the HIV viral count goes up. (23)


N-Acetyl Cysteine (NAC)

Two amino acids in particular, cystine and cysteine, have been found lacking in the blood of people with AIDS. Both are important immune system nutrients. (24) In one recent study, AIDS sufferers who took supplements of N-acetyl cysteine survived twice as long as those who did not. (25) Cysteine helps the body produce "glutathione," a protein used by the liver to neutralize toxins. Adding high doses of glutathione to AZT seems to create a synergistic effect that improves the therapeutic result. (26)


Lactobacillus acidophilus

Malabsorption and maldigestion are common problems in AIDS. (27) Poor digestive function can burden the immune system, aggravate symptoms, and contribute to weight loss. Probiotic supplements contain "friendly flora," the beneficial bacteria such as acidophilus and bifidus. These good bacteria are essential for everyone, especially individuals with AIDS; they improve digestion, support immunity, and foster healthy elimination.


L-Glutamine

L Glutamine is an amino acid that does a number of things to help the person with AIDS. It heals and strengthens the membrane lining of the intestinal tract, retards the breakdown of muscle tissue, and stimulates immune function. (28) , (29) , (30)


Vitamin B1

People with AIDS may be deficient in thiamine (vitamin B1). Studies have found brain damage in AIDS sufferers that resembles a type of brain disease caused by thiamine deficiency. Anyone diagnosed with AIDS or AIDS-related complex should take extra vitamin B1. (31)


Sterols (Sitosterol) and Sterolins (Sitosterolin)

There are many chemical constituents (termed phytochemicals) found in plant medicines that have beneficial pharmacological effects in humans. Some bioactive phytochemicals include tannins, resins, polysaccharides, saponins, glycosides, and volatile oils among others. Recent literature has reported that two of these phytochemicals, sterols and sterolins (plant "fats"), occur naturally in fruits, vegetables, seeds, and nuts and have clinically beneficial effects in human subjects in many conditions.

Sterol is found in all plant-based foods, and sterolin is a glucoside moiety joined to the sterol chemical structure. Both sterols and sterolins were identified as early as 1922. In the natural state, these plant "fats" are bound to the fibers of the plant, making the sterols and sterolins difficult to be absorbed during the normal transit of digested food through our gut. Seeds are the richest source of the sterols and sterolins, but are usually removed during processing by the food industry.

Plant sterols and sterolins have been reported to be effective adjunctive agents in the management and treatment of disease states such as high cholesterol levels, benign prostatic hyperplasia, pulmonary tuberculosis, and stress-induced immune suppression, and HIV among others. (32) , (33) , (34) , (35) , (36) Some of the most promising uses of these plant "fats" is in the management of autoimmune disorders such as lupus, multiple sclerosis, rheumatoid arthritis, and myasthenia gravis. Of note is that the sterols should be combined with sterolin in order to be an effective agent for the immune system. (37)

Sterols and sterolins have been reported to modulate the function of T-cells, significantly enhancing the proliferation of the CD-4 TH-1 cells and increasing the production of the interleukin 2 (IL2) and gamma-interferon (FN-g and IFN-y). (38) These results indicate that sterols and sterolins are adaptogenic in that they modulate the immune and stress response.

Care should be taken if an individual is taking immunosuppressive agents. Based on pharmacology, If an individual is taking hypocholesterolemic agents concurrently with plant sterols and sterolins, a dosage adjustment in the pharmaceutical medication may be necessary.

Herbal Suplementation


Arabinoxylane

Arabinoxylane is a dietary fiber product made from rice bran that has been enzymatically treated with an extract from three medicinal mushrooms: Shiitake, Kawaratake, and Suehirotake. (39) Arabinoxylane shows great promise not only for general immune support, but also in diseases of the immune system such as cancer and HIV. (40)

Arabinoxylane demonstrates anti-HIV activity in the test tube, inhibiting replication of the virus. (41) In humans, 2 months of arabinoxylane consumption has increased the responsiveness of both T cells and the immune system’s antibody-producers, the B cells.


Reishi Mushroom

Called the "mushroom of immortality" in China, reishi has long been used as a tonic and strengthening medicine that increases intellectual capacity and memory, promotes agility, and lengthens life span. (42) Reishi is rich in "polysaccharides," which are complex sugars found in many plants that stimulate the immune system. Reishi is reported to have some of the most active polysaccharides in the plant kingdom. Reishi has antioxidant properties, and it lowers blood pressure, regulates blood sugar, protects the liver against free radicals, and helps the body fight viruses.

Animal research finds that reishi enhances endurance by helping cells use oxygen more efficiently to generate energy. (43) Reishi also neutralizes some of the more potent free radicals in the body. (44)

Along with polysaccharides, reishi contains flavnoid-like compounds called "terpenes." Like most flavonoids, terpenes are free radical neutralizing antioxidants. (45) Test tube research suggests that terpenes in reishi may act like natural protease inhibitors to thwart proliferation of the HIV virus. (46)


Shiitake Mushroom

Shiitake is another mushroom long popular in the Orient that may help fight HIV. Shiitake has been used in Traditional Chinese Medicine for thousands of years. Shiitake has a host of immune support properties. Extracts of the mycelia, the fruiting body underneath the mushroom cap, activate T helper cells, increase B cell numbers, boost antibody production, and reinforce a key immune substance called "interleukin-1." (47) , (48)

Shiitake contains an ingredient called "lentinan" that shows an ability to treat HIV infection, both in the test tube and animals. (49) Shiitaki extract compares favorably to AZT in anti-viral activity. (50) A substance was recently isolated from the mushroom that acts as a protease inhibitor. (51) Along with its immune-enhancing properties, lentinan shows signs of being an anti-cancer agent. (52) , (53)


St. John's Wort

St. John’s wort is widely prescribed by European physicians for its effectiveness in treating mild to moderate depression. It has gained popularity among AIDS sufferers and indeed, St. John’s wort demonstrates anti-viral and immune supportive properties in some studies. (54) , (55) However, large doses must be taken for it to work. One recent study reported no positive results using St. John’s wort as an antiretroviral agent. (56) Unfortunately, high doses of St. John’s Wort can have side effects. St. Johns’ wort should be used only under a physician’s supervision by anyone taking "protease inhibitor" HIV medications. (57)


Olive Leaf

Olive trees are widely cultivated throughout Mediterranean countries for its universally popular fruit. But olive trees have more to offer that just the olive and its delicious, healthful oil. The olive leaf has been used as a traditional medicine in health conditions including malaria, infections, cardiovascular diseases, and for improving general well being. Olive leaf contains a key active ingredient called "oleuropein," that may have anti-viral properties, making it a potentially helpful herb in lupus. Oleuropein is also an anti-oxidant, which may give it a role in helping to prevent cardiovascular disease.

Olive leaf extract has been reported to be an effective antimicrobial agent against a wide variety of disease causing bacteria, including Salmonella, Staph aureus, Klebsiella, and E. coli. (58) These organisms are some of the major causes in respiratory and intestinal infections. Research credits oleuropein for olive leaf’s anti-microbial properties. (59) , (60) Lab studies have found that oleuropein stimulates activity of immune cells called "macrophages" which serve as the body’s garbage collectors to remove toxins and destroy foreign organisms. (61)

Nearly forty years ago, researchers began testing a synthetic derivative of oleuropein called calcium elenolate as an anti-viral drug. (62) , (63) Though it showed strong anti-viral properties in the test tube, this was never followed up, as calcium elenolate was found to be inactivated by proteins in the blood.


Larch Arabinogalactan

Arabinogalactans are a class of complex sugars that may have immune benefits applicable in HIV and AIDS. (64) Derived from the Larch tree, arabinogalactins, also known as "LA," could be helpful for people with recurring immune system problems including colds and influenza, chronic fatigue and viral hepatitis, and HIV infection.

LA is reported to stimulate various components of the immune system such as killer cells, complement protein and interferon, with anti-cancer as well as anti-viral effects. (65) , (66) , (67) , (68) , (69) , (70)


Milk Thistle

Historically, milk thistle was used as a tonic for the digestive system and the liver. (71) Given the liver’s role as the body’s detoxifier and blood filter, maintaining liver health is important for people with HIV and AIDS. Milk thistle contains flavonoids known collectively as "silymarin," that protect the liver against toxins and free radicals. (72) , (73) , (74)

Silymarin blocks the passage of toxins into the liver cells and stimulates regeneration of liver cells. It also protects liver tissue from inflammation and boosts the liver’s reserves of glutathione, a key antioxidant protein that helps the liver neutralize toxins. (75) , (76) In clinical studies, silymarin has been used to successfully treat liver diseases such as hepatitis and reverse liver damage caused by toxic chemicals. (77) , (78)

Diet & Lifestyle

    Get plenty of rest. Lymphatic massage may be of benefit to help drain toxins from the body. Eat a yeast free diet. Avoid refined sugar. Avoid gluten containing carbohydrates such as wheat, oats, and rye. Select nutrient dense foods such as vegetables fruits, whole grains.

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