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The Role of Antioxidants in HIV Therapy: A Literature Review

Louise Short, MD; Theodore Hersh, MD
Thione International, Inc.
Presented by title, 2001 United States Conference on AIDS

Objective: Approximately 33.6 million people are infected with HIV world-wide. Due to lack of access to protease inhibitors and other therapies in the developing world, and new recommendations in the United States that standard drug treatment be postponed until the immune system shows signs of weakening, other less expensive treatments modalities that boost the immune system of HIV infected individuals are critically needed. The objective of this presentation is to explore the role of antioxidants, which are relatively inexpensive and widely available, in HIV therapy.

Methods: Several studies have shown that glutathione (GSH), the body's main intracellular defense mechanism against oxidative stress, may play a significant role in decreasing HIV viral replication, and in improving the survival of HIV+ individuals. This presentation is a review of the literature on antioxidants and HIV.

Results: In vitro studies demonstrate that low intracellular GSH levels alter T cell function, decrease cell survival, increase HIV replication, and increase activation of enzymes associated with viral replication. A study in HIV+ humans has shown that repletion of whole blood GSH levels is associated with statistically significant increased survival. Data on GSH in combination with conventional antiretrovirals in a mouse model showed that high dose GSH and AZT together had synergistic effects. These included reduction of splenomegaly and lymphadenopathy, a marked reduction of proviral DNA in the organs, and a partial restoration of the ability of T and B cells to regenerate. HIV + individuals may also have low levels of other vital antioxidants including vitamins A, C and E, and important micro-nutrients such as selenium, magnesium, zinc and copper. The GSH cycle requires these antioxidant partners to maintain cellular antioxidant defenses in combating toxic oxygen and other free radicals.

Conclusions: Both the in vitro literature as well as the limited data in humans provide strong evidence for the beneficial effect of GSH as either a primary treatment for HIV in those areas of the world where other therapies are not available, or as an adjunct to other known therapies including AZT and protease inhibitors. Recent scientific studies illustrate that all antioxidants are not equal and combinations of synergistic antioxidants may be far superior to singular antioxidants for a variety of medical applications, including HIV therapy.

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