Description
AIDS is the leading cause of death among men and the fourth leading cause of death among women 25 to 44 years of age. With modern technology, scientists hypothesize that AIDS has been in the American population since the 1950's, earlier than previously thought. It was first recognized as a clinical syndrome in 1984 and is quickly becoming one of the most prevalent infectious diseases.
AIDS was originally thought of as a "gay man's" disease, since the majority of cases seen in the 1980's were primarily gay men. However, Human Immunodeficiency Virus (HIV), the virus that is believed to cause AIDS, does not discriminate.
HIV Transmission
The virus is transmitted by contaminated blood and other body fluids. One group considered at high risk include people with multiple sexual partners who engage in unprotected sex. Wearing a condom, however, does not afford you with 100% security. Other high risk groups include IV drug users (sharing needles) and their sexual partners and people who received blood transfusions or blood products before blood was screened for HIV.
HIV can be passed by an infected mother to her child during pregnancy or delivery or post-partum in breast milk. Encouragingly, efforts to increase public awareness about HIV seem to have caused a leveling off of the incidence of HIV infection among the gay community. Despite these efforts, there is an alarming rise in the incidence of HIV infection among heterosexual women and children, especially teens.
HIV Strains & Functions
There are two strains of HIV; HIV-1 and HIV-2. AIDS in the Western Hemisphere primarily results from HIV-1 infection with HIV-1 while African cases are predominately due to HIV-2. One theory suggests both strains originated in Africa. HIV belongs to a family of viruses known as Lentivirinae. "Lenti" is the Latin word for "slow", and is used to describe this family of viruses as they cause disease slowly.
HIV is a retrovirus. It contains two strands of RNA (genetic material) and an enzyme called "reverse transcriptase". The virus uses this enzyme to create a single strand of DNA (another form of genetic material) from the strands of RNA in a process called "reverse transcription". The DNA is then processed to form a single piece of double-stranded DNA. In this form, the viral genes can be incorporated into human DNA. It can exist for a long period of time in a latent state and the infected cell may show no outward sign of infection. Eventually, and for unknown reasons, viral synthesis begins. New viral particles are produced and released into the blood stream to infect other cells.
Infection Stages
There are six clinical stages of HIV infection. These stages are based on the CD4+ T cell count, CD4+ T cell function, the presence of or stage of lymphadenopathy, skin tests, and the presence of opportunistic infections.
Stage 0 represents the time of initial infection. This stage can be asymptomatic (without symptoms), or can be accompanied by mild, flu-like, symptoms. It is often misdiagnosed as the flu or infectious mononucleosis, with fever, swollen lymph nodes, fatigue, and perhaps a rash. These symptoms last only a few weeks at most while this stage can last a few weeks or up to a year. During this time, a large number of CD4+ T cells are infected and killed by HIV and a large number of viral particles are produced. The body produces anti-HIV antibodies and a person is then said to "seroconvert". The immune system is able to clear the virus from circulation and reduce infection of new cells. By the end of this stage, CD4+ T cell numbers usually return close to normal levels.
The next stage begins with the diagnosis of HIV infection. A person in Stage 1 is said to be "seropositive" for the anti-HIV antibody (the antibody is found in their blood), or simply "HIV positive". People are usually asymptomatic during this stage, but some may begin to experience various central nervous system disorders ranging from headaches to encephalitis. These symptoms often disappear within a few weeks. At this point, only a small percentage of CD4+ T cells in the bloodstream are infected with HIV and most of them have only one copy of the viral genome in a latent state. HIV continues to actively replicate, however, in lymphoid tissue, brain and intestinal cells, and other sites of the body.
HIV continues to destroy lymphoid tissue and the thymus gland and the immune system is chronically activated by HIV. This continues to gradually deplete the body of CD4+ T cells in a manner yet unknown. We are now at Stage 2 of infection, which is marked by lymphadenopathy lasting for more than 2 months (chronic). The enlargement of the lymph glands is due to over-stimulation of B cells. This leads to the production of a large number of non-functional antibodies. Stage 2 can last anywhere from three to five years.
During stage 3, there is a persistent drop of CD4+ T cell numbers to less than 400/mm3 of whole blood (normal numbers are approximately 550/mm3 of whole blood). This stage usually lasts approximately eighteen months.
Stage 4 is characterized by the impairment of "cell-mediated immunity" and is demonstrated by the failure to respond to three of four routine skin tests. Cell-mediated immunity refers to the part of the immune response initiated by T cells and mediated by T cells and/or macrophages.
Stage 5 entails the development of "anergy". Anergy denotes the inability of the body to generate a sensitivity or allergic reaction to substances that it should react to, or has known to be reactive to in the past. This stage can last one to two years and is often marked by the presence of thrush and other viral or fungal infections.
Stage 6 refers to the presence of opportunistic infections. The patient's CD4+ T cell count is extremely low (100/mm3 of whole blood or less). Most patients die within two years of the beginning of this stage.
In all, it can be ten or more years that pass between initial HIV infection and death caused by an opportunistic infection in AIDS. Efforts are geared towards turning AIDS into a chronic disease instead of a terminal illness. A number of scientists are trying to create an HIV vaccine, but are having great difficulty as HIV mutates so rapidly. In fact, it has been found that no two viral isolates from the same person contain the same genetic material, likening this rapid sort of mutation to that of a cold or flu virus.
HIV & CD4
Note: This section explains the physiological aspects of HIV & CD4 interaction and is quite technical. You may skip this section and continue with Symptoms and Signs, which follows.
HIV infects cells that have the CD4 receptor on their cell membrane. These receptors are found in high numbers on T helper cells/lymphocytes, i.e., CD4+ T cells/lymphocytes, which are the primary target of HIV.
CD4+ T cells comprise 60 to 70 percent of all circulating T cells. T cells collectively confir what is called cell-mediated immunity. CD4+ T cells respond to foreign particles (antigens) that have bound to the surface of macrophages and B cells. The CD4 receptors on the T cells bind to other specific molecules that are normally found on the surface of other immune system cells. This starts a cascade of reactions to fight the parasite that has infected the body. CD4+ T cells also produce growth factors to stimulate the proliferation and differentiation of B cells, stimulate antibody production, and release interlukin-2 (IL-2), which increases the activity of other types of T cells. Given their critical role in antigen defence, a reduction in the number of CD4+ T cells can have a profound effect on several components of the immune system and thus the integrity of the immune system as a whole.
HIV has molecules on its viral coat that are similar to the molecules on the cells that bind to CD4 receptors. These HIV molecules are called gp120. Once the viral gp120 molecule has bound with the CD4 receptor on the surface of a host cell, another protein on the viral coat, gp41initiates fusion of the two surfaces. At this point, HIV RNA and reverse transcriptase are released into the host cell. This process can occur between HIV and any cell that carries the CD4 receptor on its surface.
As mentioned above, CD4+ T cells carry this receptor and are the primary target for HIV. Other cells carry this receptor as well, including monocytes, macrophages, some B cells, and even some brain and intestinal cells. Brain and intestinal cells, however, express very few CD4 molecules on their cell surface. Monocytes and macrophages are not killed by HIV and are thought to act as reservoirs for the virus. It is also believed that monocyte infection plays an integral role in the entry of HIV into the brain, causing neurological symptoms. The infection of CD4+ T cells ultimately causes the destruction of the immune system and resulting impaired defences against viruses, fungi, parasites and certain bacteria. This situation leaves AIDS patients in a life-threatening situation.
It is not known what causes latent state HIV to become active. Exactly how HIV reduces CD4+ T cell numbers is also unknown, but some theories exist. One theory proposes that infected cells begin to process HIV genetic information and start to express the gp120 protein on the cell surface. The gp120 protein on the surface of these T cells then attach to CD4 molecules on the surface of uninfected T cells. The membranes fuse and another T cell is infected. Eventually, many cells fuse to produce multinucleated giant cells called syncitia. One HIV-infected T cell may eventually bind and fuse with up to 50 uninfected T cells. After giant cell formation occurs, the cells lose immune function and die.
A second theory focuses on the destruction of the thymus gland by HIV. The thymus gland is typically not a major source of T cells in adults, but it is theorized that when T cell numbers are very low, the thymus becomes important in replacing them. If the thymus is destroyed, T cells cannot be replenished when numbers drop.
A third theory proposes that HIV kills the CD4+ T cell directly or makes them a target for other immune cells to destroy. This most likely occurs in lymphoid tissue. In addition, the virus can shed free gp120 proteins into circulation which can bind to CD4+ T cells. They then become activated, express the viral protein on their cell surface, and are targeted and destroyed by other cells of the immune system.
It seems most likely that an overall process combining all three theories causes the CD4+ T cell decline, leading to the ultimate destruction of the immune system. Thus, HIV causes a persistent infection with a low level of activity throughout most of its course, during which you are almost asymptomatic.
Symptoms and Signs:
The following is the definition for AIDS adopted in the United States in 1993:
1. A positive test for Human Immunodeficiency Virus infection
2(a) A CD4+ T cell number of less than 200/mm3 of whole blood (normal CD4+ T cell numbers are 750 ± 250/mm3 of whole blood)
OR
2(b) A CD4+ T cell number of less than or equal to 200/mm3 of whole blood and at least one of a fungal disease, bacterial disease, viral disease, malignant disease, or recurrent pneumonia due to any agent.
An early manifestation of AIDS is called AIDS-related complex (ARC). This occurs in people who have not yet developed deficient immune function. Symptoms include fever, generalized lymphadenopathy, diarrhea, and weight loss.
Symptoms and signs experienced with AIDS are summarized in the various opportunistic infections and cancers listed under What to Expect, below.
Causes:
AIDS is caused by the human immunodeficiency virus (HIV). Although virtually all people who are HIV positive eventually get AIDS, not everyone does. Some researchers believe that the presence of other STDs increase the risk of contracting HIV and also increase the chance of developing AIDS. Those who have not developed AIDS are studied intensely to determine variations between this group and the rest of the HIV positive population.
What to Expect:
Virtually every (but not all) HIV positive people develop AIDS. To date, AIDS is fatal. Death is not directly due to the virus itself, but rather opportunistic infections that arise due to the severely depressed state of the immune system. Opportunistic infections are those that are not often seen in people with a healthy and properly functioning immune system. These infections are the leading cause of death among AIDS patients. Many of these infections are outlined below.
Fungal Infections
The most common opportunistic infection includes pneumonia caused by the fungus Pneumocystis carinii. This is the major cause of death among AIDS patients. You may only have a slight fever or none at all. You are likely to be extremely weak, have shortness of breath or difficulty breathing, and your skin and mucous membranes may be bluish or purplish (cyanotic). This form of infection is also known as interstitial plasma cell pneumonia or pneumocytosis.
Many AIDS patients also suffer from systemic fungal infections typically caused by Candida albicans. Candidiasis is often one of the first symptoms in an HIV positive person, along with oral hairy leukoplakia (see below). For more information see Candidiasis.
Toxoplasmosis is a disease caused by the protozoan Toxoplasma gondii. Symptoms include fever, lymphadenopathy, headache, myalgia, arthralgia, malaise, and fatigue. It can also lead to encephalomyelitis, corioretinopathy, maculopapular rash, and pneumonitis. Toxoplasmosis is often fatal due to the encephalopathy that occurs. This disease can be passed through the placenta to the fetus and several abnormalities may occur.
Isosporiasis is a disease caused by infection of the small intestine with one of a number of species of the genus Isospora. Though an infection is quite likely, an intact immune system keeps this fungus in check. AIDS patients infected by this organism suffer from mucousy diarrhea. It is very resistant to treatment.
Infection by Cryptococcus neoformans causes a disease called cryptococcosis and can be a pulmonary, disseminated, or meningeal infection. The most common form involves the central nervous system (CNS) and causes subacute or chronic meningitis. This infection is also known as Busse-Buschke disease.
Cryptosporidiosis is a waterborne, enteric disease that manifests as prolonged, severe diarrhea. It is caused by protozoa of the genus Cryptosporidium and can be fatal.
Coccidioidomycosis is caused by inhaling dust particles containing spores of the fungus Coccidioidomycosis immitis. This is a systemic disease that can be benign, severe, or fatal. If benign, lesions occur in the upper respiratory tract and the lungs. In more severe cases, lesions spread to other organs, bones, joints, skin, and subcutaneous tissues. This disease is also known as Posadas disease.
Infection with Histoplasma capsulatum can cause a disease called histoplasmosis. This is a systemic fungal disease acquired by the inhalation of spores in soil dust and leads to primary benign pneumonitis. Occasionally, lesions form in the lungs. Signs and symptoms include fever, emaciation, splenomegaly (enlarged spleen), and leukopenia (low leukocyte count). This disease is also known as Darling's disease.
Viral Infections
Along with candidiasis, oral hairy leukoplakia are one of the first symptoms of HIV infection and is cause by the Epstien-Barr virus (EBV). White, raised lesions with a corrugated or "hairy" surface appear on the tongue. These lesions may become cancerous and may or may not spontaneously regress.
Shingles is a disease caused by the activation of latent varicella zoster virus in a dorsal nerve root and is the same virus that causes chicken pox. The disease is characterized by the presence of small vesicles on one side of the body and follow the course of a nerve. It may be accompanied or followed by severe, post-herpetic pain.
Cytomegalovirus (CMV) can cause "CMV disease" or cytomegalic inclusion disease. This group of viruses belong to the Herpesviridae family and have special affinity for salivary glands, although it can affect various organs. Signs and symptoms include fever, jaundice, hepatomegaly (enlargement of the liver), splenomegaly (enlargement of the spleen), purpura, and thrombocytopenia. This disease can be passed on to the fetus and may result in malformation and even death. Latent CMV can be reactivated and cause pneumonia, encephalitis, blindness, and inflammation of the gastrointestinal tract.
Progressive multifocal leukoencephalopathy (PML) is a rare, subacute, disease caused by JC virus (a human polyoma virus). It is characterized by areas of demyelination of nerve cells that comprise the white matter of the nervous system and severely altered neuroglia.
Some people with AIDS suffer from bronchitis caused by herpes simplex virus (see Bronchitis for more information). This virus also causes persistent and painful sores in the skin around the mouth, genitals, or anus.
Bacterial Infections
Tuberculosis is caused by Mycobacterium tuberculosis. It has the ability to affect almost any tissue or organ of the body, but most commonly affects the lungs. Lesions are referred to as tubercles and can undergo a process called caseation necrosis, whereby the tissue dies. Local symptoms vary, but systemic symptoms include sepsis, with fever, sweats, and emaciation. If not treated, it is usually fatal.
Mycobacterium avium-intracellulare complex (MAC) is a difficult infection to treat and is antibiotic resistant. M. avium causes TB in birds and has just recently been linked to opportunistic infections in humans.
Recurrent Salmonella septicemia is a systemic disease. It is caused by the recurrent spread of Salmonella bacteria and their toxins via the bloodstream.
Cancers
Kaposi's sarcoma (KS) is a rare form of cancer that often appears in people with AIDS. It is a cancer of the cells that line the walls of blood vessels and leaves characteristic purple patches or lesions on the skin, aiding diagnosis. It used to be a very rare tumour of endothelial cells and mesenchymal spindle cells. AIDS-related KS differs from the classic form in that the tumours can appear anywhere on the body, instead of just the lower limbs. KS can be disseminated to internal organs, its spread is more aggressive, and its pathogenesis is poorly understood. AIDS-related KS appears mostly in males. The mode of HIV infection may play a significant role as it has been noticed that of the men that were infected due to transfusion of tainted blood products, very few develop KS. It is thought that another venerally-transmitted organism is also implicated in the development of AIDS-related KS.
Cervical cancer is a malignant neoplasm and is derived from the epithelial tissue of the cervix. The risk of developing this cancer is increased in women with HIV.
Non-Hodgkin's lymphoma is among the most common AIDS-related malignancies. It is defined as a lymphoma other than Hodgkin's disease and is divided into low, intermediate, and high-grade malignancy, differing in ease of treatment and prognosis.
Burkitt's lymphoma is a form of malignant lymphoma caused by EBV. EBV that latently infects cells can sometimes undergo malignant transformation. If T cells fail to respond to and destroy this transformation, this type of B-cell lymphoma may occur.
Other malignant disease include primary lymphoma of the brain and immunoblastic lymphoma.
Other
AIDS dementia complex (ADC) is subacute or chronic encephalitis associated with HIV-1 infection. It is the most common neurological complication in later stages of AIDS and manifests as a progressive dementia with motor abnormalities. The dementia includes loss of cognitive and intellectual function with disorientation, impairment of memory, judgement, and intellect. This occurs without impairment of perception or consciousness. ADC is also known as HIV-related encephalopathy.
People with AIDS often suffer from a number of neurological problems, some of them related to balance and gait (method of foot movement). Often, people in later stages of the disease are unsteady on their feet, tend to loose their balance, and fall.
HIV wasting syndrome is a condition whereby you lose 10% of your body weight and is associated with diarrhea or fever lasting over one month.
Idiopathic thrombocytopenic purpura (ITP) is a systemic illness of unknown cause (idiopathic). Extensive purplish patches (ecchymoses) and hemorrhages occur from mucous membranes. Platelet counts are very low due to destruction by macrophages. There is a potential for life-threatening bleeding to occur, especially intracranially. This disease is also known as immune thrombocytopenic purpura, purpura hemorrhagica (1), and thrombopenic purpura.
Cervical dysplasia is an abnormal tissue development of the cervix. It seems to regress frequently but has the potential to develop into a carcinoma after long periods of time.
Pelvic inflammatory disease (PID) is an acute or chronic inflammation in the female pelvic cavity, where suppurative lesions form in the upper genital tract. It is most commonly caused by STDs that have made their way up to the uterus, fallopian tubes, or ovaries due to childbirth, intercourse, or surgical procedures such as the insertion of an intrauterine device (IUD) or abortion. PID can be symptomatic or asymptomatic. Scarring of the lesions occurs and this can lead to infertility. It may also increase the risk of ectopic pregnancy (implantation and development of a fetus at a site other than the uterus).
People with AIDS often suffer from peripheral neuropathies. These are diseases involving the peripheral nervous system. Symptoms can include numbness and tingling of extremities, pain, and weakness.
Chronic ulcers are also a problem for people with AIDS see Ulcer for more information. Many people with AIDS also suffer from decubitus ulcers or pressure sores if bed ridden. These ulcers and sores appear over bony prominence and are caused by a circulatory defect.
Enteric helminthic infections often occur in people with AIDS. These are infections with intestinal worms, causing dysentery with frequent, watery, stools with occasional blood and mucous, pain, fever, dehydration and painful spasm of the anal sphincter. In AIDS patients, this is often caused by the nematode Strongyloides stercoralis, a small roundworm that is widespread in all tropical regions.
Remedies
First and foremost, if you have been tested for HIV and the test was positive, get re-tested to rule out a false positive, which can happen. If your second test comes back positive, see your naturopath or other health practitioner to discuss the most suitable course of action to meet your needs. Start with boosting your immune system through various methods outlined below.
Be sure to keep yourself informed. Read up on everything you can about the disease, and continue to do so, as new developments occur frequently.
Conventional Approaches
Several chemotherapeutic agents have evolved which attempt to slow the progression of AIDS. Some of these are quite toxic with long-term use. In addition, some strains of HIV are resistant to the effects of some of these drugs, mostly likely due to the virus' high rate of mutation. People often take more than one drug at a time in mixtures known as "cocktails", which seem to be more effective than taking one drug alone.
Amino Acids
Arginine supplementation may enhance NK activity in people with HIV infection and AIDS. This amino acid is found in brown rice, carob, coconut and chocolate, dairy products, gelatin, meat, oatmeal, oats, nuts, raisins, sesame seeds, soy, sunflower seeds, wheat germ, whole wheat, and all protein-rich foods. L-arginine is available as part of a multi-amino acid complex and in protein powder supplements. Depending on the country in which you live, arginine may also be available as an isolated supplement in capsule or tablet form. You may require a prescription
Carnitine deficiency may lead to metabolic dysfunction. As a result, you should supplement with carnitine if experiencing HIV-related wasting or have high serum triglycerides. Use of AZT can also deplete L-carnitine in tissues, leading to myopathies and impaired lymphocyte function. Supplementation can minimize these side effects. Take 2,000mg daily.
A glutamine deficiency may be a contributing factor in wasting associated with HIV-infection. It is also associated with atrophy and degeneration of the small intestine, where the majority of food breakdown and nutrient absorption occurs. Glutamine has also been shown to slow malabsorption. Supplementation may be beneficial. Oat bran is also high in glutamine and certain fibres. It also protects and reconditions the intestinal mucosa. Add 1 to 2 tablespoons to cereal or other foods.
Glutathione may be deficient in HIV positive people. Supplementation with GSH has similar results to NAC, but to a lesser degree. Take as part of a multi-amino acid complex.
Lysine is useful for the treatment of mouth sores and herpes outbreaks. Ideal sources include amaranth, cheese, chicken, eggs, fish, lima beans, milk, red meat, potatoes, soy, yeast, and all protein-rich foods. Lysine is also found as part of a multi-amino acid complex and protein powder supplements. It is also available as an individual supplement, mostly to treat cold sores and herpes simplex infection. Depending on the country in which you live, lysine may also be available as an isolated supplement in capsule or tablet form. You may require a prescription
N-acetylcysteine (NAC) is the acetylated form of cysteine and can be supplemented to raise glutathione levels in the body, increasing energy levels and strengthening the immune system. This amino acid combo of cysteine, glutamic acid, and glycine has also been shown to inhibit reverse transcriptase activity, thus inhibiting HIV replication. NAC stimulates T cells and cysteine deficiency may be associated with T cell dysfunction. NAC can also increase CD4+ T cell numbers. When taken with vitamin C, they potentiate each other's activity. A group of studies suggest that AIDS may result from a viral-induced cysteine deficiency. Another source states that NAC, along with L-carnitine, may prevent/counteract the weight loss that often occurs in people with AIDS. Take 1,000mg twice daily.
Antioxidants
Alpha-lipoic acid has been shown to increase intracellular glutathione levels in T cells. It has also been shown to inhibit HIV activation, gene expression, and ultimately, replication. This antioxidant can also increase blood levels of vitamin C and CD4 T cells. Alpha-lipoic acid is found mostly in meat products, but can also be obtained from dark leafy green vegetables, especially spinach and broccoli. If supplementing, doses usually range between 60 and 100mg.
Green tea can be taken daily to help cleanse toxins from the body. Place 2 teaspoons of green tea leaves in one cup hot (not boiling) water and steep for 3 to 4 minutes. The longer the infusion, the more bitter green tea becomes. Boiling water destroys some of the beneficial elements of green tea. Allow the water to stop boiling before adding the leaves. Use a ceramic, glass, or earthenware mug. Drink 1 to 2 cups daily
Grape Seed Extract and pycnogenol are powerful antioxidants. Take 150mg grape seed extract daily, in divided doses, and 25 to 100mg pycnogenol.
Foods
Flaxseed oil and cod liver oil contain certain substances that can selectively kill HIV-infected cells. Take 1 tablespoon of either oil 1 to 2 times daily. Be sure not to cook with or heat flaxseed oil as it will go rancid quite quickly. Add to salads, fresh vegetables, or yogurt instead.
Food Supplements
Acidophilus and Bifidus supplementation will restore beneficial bacteria counts in the digestive tract and help keep harmful bacteria at bay. It can also hinder the development of candidiasis and other fungal infections of the GI tract. It may also hinder the survival o f HIV in the female genital tract as well. Look for a dairy-free formulation with at least 2.5 billion viable cultures per capsule and keep refrigerated. Take 2 or 3 capsules daily on an empty stomach, preferably in the morning or right before bed. Supplements with Fructooligosaccharides (FOS) provide a beneficial "bed" and initial food source for the bacteria. If dairy allergies have been ruled out, you can also eat yogurt that has had either bacterial culture added.
Herbs
Astragalus supports immune system function, increases metabolism, and also improves digestion. If using capsules, take 6g three times daily. If using a tincture, take 20 to 30 drops three times daily.
Cat's claw can be used to treat AIDS and cancer. It has immune boosting properties, can activate T cells and macrophages, and may normalize antibody production and function. Consult with your herbalist, naturopath, or other health practitioner on proper use of this herb.
Garlic has antioxidant and antiviral properties. It has been shown to be effective in disorders of the GI tract involving diarrhea. It has also been shown to inhibit CMV, herpes simplex I and II, Cryptococci, Mycobacteria, Mycoplasma, and Candida infections. It has also been shown to stimulate the activity of NK ells in AIDS patients. Take 600 to 1000mg twice daily.
Ginko biloba is known to increase cerebral blood flow and improve memory and concentration. It also shows activity against Pneumocystis carinii. Take 2 capsules two to three times daily.
Licorice root is a broad-spectrum anti-viral herb and has been shown to stimulate interferon production. Glycyrrhizin (GL), a constituent of licorice root, has been shown to be beneficial in the treatment of liver dysfunction associated with CMV infection. GL has also been shown to inhibit giant cell formation. Take 2 capsules three times daily, or 0.25 to 0.5 teaspoons solid extract as a tea one or twice daily.
Maitake mushroom has proven beneficial for people with HIV. Studies have shown it increases activity of macrophages, killer cells, and cytotoxic T cells, and demonstrates anti-HIV activity in vitro. In vivo studies have proven its ability to significantly stimulate the immune system. Take 3 capsules three times daily.
Reishi (shiitake) mushroom helps boost the immune system and has anti-cancer properties. It has been shown to stimulate cytotoxic T cells in their activity to inhibit tumours in vitro in the presence of IL-2. Reishi contains a constituent called lentinan that increases your resistance to a number of bacterial, viral (including HIV), and parasitic infections. It is also useful for fatigue. Take 3 capsules three times daily and add this mushroom to your diet.
Siberian and American ginseng can be used to deal with various symptoms. American ginseng can help with fever, irritability, night sweats, dryness, weakness, and debility. Siberian ginseng can increase energy and is a useful nerve tonic for the alleviation of stress, anxiety, and insomnia. It is also useful against various cancers. There are some contraindications for ginseng. For more information see the section on Ginseng under the Herbs index.
Silymarin, isolated from milk thistle and artichoke, is useful for supporting the liver and promotes detoxification. The extract also shows anti-tumour capabilities. Note that silymarin is not water soluble. Take 280 to 600mg milk thistle in supplement form or 20 to 30 drops tincture 3 times daily. You may also sprinkle 2 tablespoons ground milk thistle seeds on food per day.
St. John's Wort can help with depression that often accompanies the diagnosis of HIV infection. It has also proven beneficial in the treatment of nerve pain. St. John's Wort may also inhibit viral infection by preventing binding and entry of HIV into cells. One study found that when HIV was incubated with St. John's Wort, it became non-infectious. As this herb has the ability to cross the blood-brain barrier, it should be considered in the prevention or treatment of HIV infection of brain cells. Take 900mg daily in divided doses.
Lifestyle
It is very important to build a support net of friends and family. Be sure to join a support group. Being part of a larger whole helps reduce anxiety levels, depression, hostility, and hopelessness. You can learn long-term coping skills to help you deal with issues surrounding HIV infection. One study also showed that gay men who conceal their homosexuality have an increased physical health risk. Some also find it beneficial to speak to a psychotherapist to work through many problems or issues. One item of note is recent research done on the effects of spiritual practice, such as prayer and meditation, and health status of HIV positive people. There is a positive correlation between the practice of spiritual activities and health status. In fact, "health of terminally ill patients is based more on spirituality and ability to relate to others than on pathology".
Try to prevent or treat malnutrition. Impairment in immunity can occur with nutritional deficiencies which can increase susceptibility to infectious agents.
It is important to determine any food sensitivities or allergies through an elimination diet and eliminate that food from your diet. Avoid simple sugars, caffeine and alcohol, as they have negative effects on the immune system. Consume an adequate amount of protein and essential fatty acids and eat plenty of fresh fruit and vegetables, preferably organic. You must also be very choosy and careful about what you eat to avoid food poisoning, which could be very serious for someone with HIV/AIDS.
Most people with HIV have at least one mineral or vitamin deficiency, if not more. Take a multi-vitamin and chelated mineral supplement to reduce the possibility of deficiency. Avoid products containing sugar, additives, preservatives, or colourants. It may be best to take one without iron, as many viruses and bacteria rely on your body's free iron as a food source. Several possible vitamin and mineral deficiencies are listed below. Take 2 capsules twice daily, or as per the advice of your nutritionist, naturopath, or other health practitioner.
M. Murray and J. Pizzorno suggest a "protein powder smoothie". Mix 2 scoops protein powder with 1 cup of nuts or nut butter (not peanut), 1 cup of yogurt, 1 cup of fresh fruit, 1 tbsp of honey, 1 tbsp of flax seed oil, and enough rice milk or juice to make 24 fluid ounces. Drink 8 oz three times daily.
HIV positive people often have poor pancreatic output, which can lead to a variety of digestive complaints. The pancreas is often infected or undergoing neoplastic changes. Supplementing with digestive enzymes can help in the breakdown of foods necessary for absorption. Take 1 to 2 capsules with meals.
Dehydroepiandosterone (DHEA) is an adrenal steroid hormone and an intermediate in the production of testosterone and other sex hormones. DHEA deficiency may be detrimental to the immune system and hasten the progression to AIDS in HIV positive people. In some uncontrolled studies, supplementation with DHEA increased levels of circulating CD4+ T cells in some patients. It may also modestly inhibit HIV replication and acute infection of lymphocytes. This hormone must be used with caution as it is thought that high levels of DHEA in the blood are involved in the pathogenesis of Kaposi's sarcoma. Women at risk of hormone-sensitive malignancies such as breast cancer should speak to their naturopath or other health practitioner before supplementing with DHEA. If supplementing, take 5 to 10mg daily for women, 15 to 50 g daily for men.
If bedridden, turn the person several times a day to lie in various positions or on various sides of the body to retard or prevent the development of pressure sores and decubitus ulcers.
Minerals
Some experiments show that supplementation with germanium (sesquioxide) may be beneficial for AIDS patients.
Selenium deficiency is common among HIV positive and AIDS patients. Along with beta-carotene, this antioxidant mineral can improve glutathione status in HIV positive people. It has also been shown to suppress gene expression of HIV-1 in vitro and may decrease HIV-1 activation. It has been suggested that the latency period of HIV infection may depend on how long it takes for your body to deplete selenium stores. Selenium, along with other antioxidant nutrients, may reduce the risk of a mother transmitting the virus through the placenta to the fetus during pregnancy. Take 200 to 600mcg daily.
Zinc is important for immune system function and it is thought that a zinc deficiency may aid the development of some AIDS-associated disorders. And in the late stages of the disease, there is often excessive loss of zinc due to diarrhea and redistribution of zinc in tissues by the body. Zinc deficiency is also associated with an increased incidence of bacterial infections in HIV positive people. In one study, zinc supplementation was found to be beneficial in the treatment of PCP and candida infections. Some sources suggest it is better to obtain zinc from the diet rather than through supplementation. One study has correlated any amount of supplementation with zinc with a decreased survival time of AIDS patients. Other sources make no mention of any problem with supplementation. If supplementing take 150mg daily. If you do not wish to supplement with this mineral, eat zinc-rich foods such as pumpkinseeds, or take thymus gland extracts, which are high in zinc and have other immune-boosting properties. You are advised to speak to your naturopath or other health practitioner to determine the most appropriate course of action for your needs.
Miscellaneous
Quercetin, derived from yellow onion, is known to have antiviral activity, particularly against herpes simplex I and II, and HIV.
M. Murray and J. Pizzorno suggest a kidney tonic tea for people taking Indinavir to prevent kidney stone formation. They suggest a decoction of Arctostaphylus uva ursi, Zea mays, Eupatorium perfoliatum, Ezuisetum arvense, Symphytum radix, Verbascum thapsus, and Barosma betulina in equal portions. Consult with your herbalist, naturopath, or other health practitioner on preparing this tonic.
Therapies, Healing Aids, and More
Acupuncture is employed by many people to deal with different symptoms of HIV infection and AIDS. It has been shown to increase T cell proliferation and can also help with pain relief and depression.
Aromatherapy can be useful to alleviate depression and help you relax. Lavender is an excellent starter. See the dedicated section on Aromatherapy for more information.
Study after study purports the benefits of exercise on physical, emotional, and mental health, and on stabilizing and enhancing mood. Exercise is known to decrease stress levels and can ward off depression and anxiety. Aerobic exercise enhances the immune system as well. Studies with HIV positive individuals relating to exercise have been very positive and it has been shown that long-term AIDS survivors usually partake in physical fitness programs. Progressive resistance exercise during the non-acute stages of AIDS can improve muscle function and increase muscle mass. This has obvious implications if one is to experience wasting associated with AIDS at later stages of the disease.
Homeopathy can also be used for treatment of various symptoms. Consult your homeopath or naturopath to determine your constitutional remedy: the remedy that best fits you as a whole person. Your homeopath or naturopath will take a complete case history, considering all of your mental and physical ailments and match these symptoms with the symptom picture of the remedy. Some studies have been done with the effectiveness of homeopathy for HIV positive individuals with interesting results. One review article states that of 34 HIV positive individuals studied, homeopathic treatment increased CD4+ T cells in 23 of them. In another study of constitutional homeopathy, 129 asymptomatic HIV positive patients in India were treated. Of these people, 12 became seronegative (ELISA-) after 3 to 16 months of treatment. See the dedicated section on homeopathy for more information.
Hydrotherapy can be used to alleviate various symptoms. It can help eliminate toxins from the body and alleviate depression. Certain components of the immune system are increased with hydrotherapy treatments. This therapy can also help increase blood circulation and thus improve tissue oxygenation, nutrition, and detoxification.
Massage therapy is beneficial for most people with HIV or AIDS as it can help keep the skin durable, improve respiration, alleviate abdominal cramping and nausea, and reduce stress. Massage has also been shown to increase NK cell count and activity. This form of healing will also reinforce the fact that you can be touched in a caring and positive way.
Reflexology can be useful to stimulate different glands and organs.
Therapeutic touch is often reported to be beneficial.
Yoga can also be beneficial. People often report feelings of increased alertness, mental and physical energy, and enhanced mood and outlook. People also suffer less tension, fatigue confusion, depression, and anger as a result.
Vitamins
A multi-vitamin with chelated minerals is essential. Choose a product that contains no added sugars, colours, additives, or preservatives. This will provide your body with essential nutrients needed by all systems.
Vitamin A, or beta-carotene, supplementation may decrease the incidence of tumours and mortality rates for people with AIDS. It has also been suggested that supplementation with this vitamin may be useful in treating Kaposi's sarcoma. An animal study suggested that supplementation with vitamin A may reduce morbidity and mortality. A vitamin A deficiency has been related to a decrease in circulating CD4+ T cells and the accelerated development of AIDS. A human study with topical applications of retinoic acid reversed "hairy" leukoplakia in an AIDS patient. If supplementing, take 25,000 to 100,000 IU per day in divided doses. It is important, however, to keep a careful watch for vitamin A toxicity; symptoms include headaches, body aches, and excessively dry skin. If you are pregnant, consult with your naturopath or other health practitioner before supplementing with this vitamin.
One source suggests taking 150,000 IU of beta-carotene twice daily. HIV positive people have a significant deficiency of the carotenoids. Beta-carotene, along with selenium, can improve glutathione levels and reduce oxidative stress. Supplementation has been shown to decrease fever, nocturnal sweating, diarrhea, and weight loss. It may even increase CD4 cell counts. Take a natural form of beta-carotene if you choose to supplement; some research indicates that synthetic beta-carotene may increase the risk of lung cancer in smokers. Alternatively, drink two glasses of fresh carrot juice daily.
A B-complex supplement supports an overworked liver and will support your nervous system by providing it with the nutrients it needs to function properly. People with anxiety or stress (situations often coupled with depression) often benefit from additional B vitamins. Take one 50mg capsule once or twice daily. Do not take more than 50mg at one time as your body cannot absorb a larger amount in a single dosage. B complex injections may also be considered for better absorption. You must discuss this option with your naturopath or other health practitioner.
You may be deficient in vitamin B1. Some neuropathological changes similar to Wernicke's encephalopathy have been noticed in non-alcoholic AIDS patients, post-mortem. Studies also show that taking more than five times the RDA of B1 resulted in increased survival in people infected with HIV-1. Take 50mg twice daily.
Supplementation with greater than five times the RDA of B2 is associated with increased survival in people infected with HIV-1.
Vitamin B3 deficiency has been postulated to cause a chronic loss of tryptophan, causing a decrease in niacin causing leading to dementia, diarrhea, and possibly even immunosuppresion in people with AIDS. Nicotinamide, a form of vitamin B3, has been shown to inhibit acute and chronic HIV infection, and reverse the intracellular pellegra caused by HIV, both in vitro. Nicotinic acid (another form of vitamin B3) did not show similar results. Supplementation with greater than five times the RDA of B3 is associated with increased survival in people infected with HIV-1. Take up to 250mg twice daily, in divided doses.
Deficiencies of vitamin B6 have been shown to cause atrophy of lymphoid organs, a significant decrease in lymphocyte numbers, impairment of antibody activity, and IL-2 production. Studies show that supplementation with greater than two times the RDA of B6 is associated with increased survival in people infected with HIV-1. Take 100 mg twice daily.
Vitamin B12 supplementation should also be considered as poor metabolism of this mineral could reduce blood levels. This can lead to peripheral neuropathies and myelopathies. Supplementation may reverse the symptoms of these ailments. Vitamin B12 deficiencies have also been associated with the accelerated development of AIDS. If deficient, supplementation to normal levels may improve memory. It has also been suggested that supplementing with B12 and folic acid may reduce the toxicity of AZT to your body. Intramuscular injections may be required. You must discuss this option with your naturopath or other health practitioner.
Vitamin C will scavenge for free radicals. There have been several "in vitro" (test tube) studies that show promise. One in vitro experiment showed that vitamin C decreased HIV protein production in infected cells and decreased the stability of an important enzyme required for replication in extracellular viral particles. Another in vitro study showed that vitamin C significantly inhibited viral replication in chronically infected cells and also inhibited the formation of multinucleated giant cells in acutely infected cells. A clinical observation showed that supplementation to bowel tolerance can suppress symptoms and greatly reduce tendency for secondary infections in HIV positive people. When doses were maintained for several years, there was a slower depletion of CD4+ T cells which sometimes stopped or even reversed for some people. Vitamin C has also been shown to enhance the activity of NK cells. Take 1,000mg daily and increase up to bowel tolerance. Some individuals will experience diarrhea even at the lower doses. If this occurs, speak to your naturopath or other health practitioner to determine the most appropriate dosage for your needs. If you are taking an anti-viral protease inhibitor such as Indinavir, speak to your naturopath or other health practitioner before supplementing with vitamin C, as taking both may increase your risk of developing kidney stones.
Vitamin E also acts as an antioxidant and has immune-enhancing properties. It can be beneficial for the spleen and increase NK cell activity. Vitamin E may also reverse some of the side effects of AZT and helps maintain cell membrane structure. A deficiency of this vitamin has been linked to the accelerated development of AIDS. Take 400 IU daily (can increase up to 1,000 IU).
Coenzyme Q10 is a powerful antioxidant. It is deficient in people with ARC and even more deficient in people with AIDS. CoQ10 can increase CD4+ T cell numbers in the blood and increase the IgG levels in AIDS patients. Animal studies reveal that this antioxidant can protect against tumour growth and increase immunity to viruses. Take 30 to 100mg three times daily.
The absorption of folate is impaired in people with HIV, which can lead to a state of anemia. It has also been noted that AZT is more toxic than usual to bone marrow when there is a deficiency of folic acid. If supplementing, take 400mcg daily.
Actions and Remedy Listings
For More Information ...
They Conquered AIDS! True Life Adventures by S. Gregory and B Leonardo, published by True Life Publication, 1989 discusses how some people have been HIV positive for 10 years or more and are still healthy. It also has examples of people who have become negative for the HIV antibody after years of being HIV positive.
The Canadian HIV/AIDS Clearinghouse
Web: www.cpha.ca/clearinghouse_e.htm
Canadian AIDS Society
130 Albert Street, Suite 900
Ottawa (Canada) K1P 5G4
Tel.: 613.230.3580
Fax: 613.563.4998
Web: www.cdnaids.ca
Email: CASinfo@cdnaids.ca
Canadian Foundation for AIDS Research
165 University Ave.
Toronto, Ontario
M5H 3B8
Tel.: 416.947.2578
Canadian HIV/AIDS Legal Network
484 McGill Street, 4th Floor
Montréal, Québec
H2Y 2H2
Tel.: 514.397.6828
Fax: 514.397.8570
Web: www.aidslaw.ca
Email: info@aidslaw.ca
Community AIDS Treatment Information Exchange (CATIE)
517 College Street, Suite 420
Toronto, Ontario
M6G 4A2
Tel.: 416.944.1916
Fax: 416.928.2185
Toll-free in Canada : 1.800.263.1638
Web: www.catie.ca
Email: questions@catie.ca
Health Canada -- Canadian Strategy on HIV/AIDS
Web: www.hc-sc.gc.ca/hppb/hiv_aids
See also Bronchitis, Candidiasis.
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