Re: Re: "HIV", HHV-8 AND KS 25 August 2004
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James J Whitehead,
40A Josephine Avenue, London SW2 2LA

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Re: Re: Re: "HIV", HHV-8 AND KS

Dear Editor and Nicholas ,

Just to hammer home the point, the following says it far better than I.

"In addition to enhancing immunity, multivitamins may also reduce HIV replication, as indicated by the significant reduction in viral load. HIV replication in vitro is increased by oxidative stress.27 "(19e){Note reference 27 from this paper shows NAC inhibits hiv expression}.

"Components of our multivitamin supplement, particularly vitamins C and E, are potent antioxidants. In a small, randomized, placebo-controlled study of 49 HIV-positive patients, those who received daily supplements of both vitamin E (800 IU) and vitamin C (1000 mg) for three months had a significant reduction in lipid peroxidation (a measure of oxidative stress), with a trend toward a reduced viral load.28

The benefits with respect to immunologic and virologic outcomes in our study were small relative to the effects of triple antiretroviral therapy. However, the effects of multivitamins on the CD4+ cell counts and viral load were similar to, and in some cases larger than, those of early trials, which compared therapy with a single antiretroviral agent with placebo or dual therapy with single-drug treatment, as well as recent trials comparing three-drug therapy with two-drug therapy.29 In a meta- analysis of studies that evaluated treatment-mediated changes in CD4+ cell counts and viral load as surrogates for the progression of HIV disease (progression to AIDS or death), the relationships between these markers and the risk of progression were linear.30 Applying our observed reduction of 0.18 log in the viral load to this linear relation results in an increase in the time to progression to AIDS or death of approximately 30 percent, similar to the size of the effect that we observed. " (19e)

The Editorial NEJM July 2004 states."Serum and plasma measurements of vitamins and trace elements, which are imperfect indicators of body stores, have shown that deficiencies are common among HIV-infected persons, especially those who are underprivileged, such as women in developing countries, and injection-drug users. A vicious cycle has been envisaged in which undernourished HIV-infected persons have micronutrient deficiencies, leading to further immunosuppression and oxidative stress and subsequent acceleration of HIV replication and CD4+ T-cell depletion.1 ".(20b).

"We should treat oxidative stress at the earliest possibility. This requires measuring the oxidative stress markers in the blood and tailoring the treatment to the individual based on the results of these tests." (27)

Montagnier: "I strongly believe that one important factor is the activation of the T-helper cells. Consecutive T-cell receptor stimulation induces T-cell deletion by apoptosis. [4] Recognizing the importance of apoptosis in AIDS progression may have dramatic implications for developing new treatments for AIDS. Apoptosis may induce oxidative stress. We know also that oxidative stress can mediate apoptosis. This is a circular cascade."(27)

All of the subjects reported, with no exception, a sense of improved well-being by the second week of L-carnitine treatment." (57).

In 1985, Pompidou et al. (1985b) and more recently many other researchers including Anthony Fauci have shown that reducing agents suppress the expression of HIV (Scheib et al., 1987; Bitterlich et al., 1989; Kalebic et al., 1991)." (69)

"Fawzi and colleagues' study of multivitamin supplementation should stimulate broader discussion of the role of nutrition in patients with AIDS in the developing world. With its effects on morbidity, mortality, and poverty, the epidemic of HIV infection and AIDS has worsened food security in Africa, especially in the southern part of the continent, the area most affected by HIV. HIV disease increases metabolic requirements, suppresses appetite, may impair swallowing by causing oral and esophageal opportunistic infections, may be associated with malabsorption due to various gastroenteropathies, and perhaps most important, results in progressive disability and impoverishment, with a consequent inability to raise or afford food. Undernutrition also interacts with HIV in a variety of ways. Undernutrition may promote HIV transmission, for example, when sex is exchanged for money to buy food for oneself and one's family. The clinical picture of the HIV wasting syndrome (also known as the "slim disease"), a characteristic manifestation of AIDS in Africa, results in large part from undernutrition in the face of opportunistic illnesses, especially tuberculosis, which itself may be made more likely by inadequate food intake.8,9 Whatever its cause, a reduced body-mass index is a strong predictor of death." (20b)

All studies show pronounced alterations in plasma and muscle amino acid status in patients with chronic obstructive pulmonary disease but no consistent 'disease specific' pattern for most amino acids. Variability is likely influenced by the heterogeneity of the disease with respect to lung function and nutritional state. Nevertheless, general consistency exists in chronic obstructive pulmonary disease with respect to (1) a reduced plasma branched-chain amino acid level, and (2) a decreased muscle glutamate concentration. Alterations in branched-chain amino acid metabolism appear to be influenced by the degree of muscle wasting, while the reduction in muscle glutamate is related to the diffusing capacity as a hallmark of emphysema. The reduction in glutamate status is associated with reduced muscle glutathione levels and appears to be linked to enhanced glycolysis as evidenced from an accelerated increase in plasma lactate."(42)

"Weight loss and wasting have long been established as strong predictors of mortality in HIV-infected patients. Today, despite the effectiveness of highly active antiretroviral therapy (HAART), there is evidence that HIV-related wasting is still an important comorbidity in many patients"(25)

"Severe weight loss in HIV is associated with decreased length of survival. It is unclear whether mild weight loss is associated with an increased risk of death or opportunistic complications of HIV".(26) "Among those who lost 5% to 10% of their body weight, the relative risk of individual opportunistic complications increased significantly, including Pneumocystis carinii pneumonia (PCP) (1.61; p < .01), cytomegalovirus (CMV) (2.33; p < .001), and Mycobacterium avium complex (MAC) (1.81; p < .01). As little as 5%t weight loss over a 4-month period is associated with increased risk of death and opportunistic complications in HIV. A weight loss of 5% to 10% is also associated with an increased risk of individual opportunistic complications."(26)

"Wasting, particularly loss of lean body mass, is associated with early mortality (68,69) and susceptibility to opportunistic infections (48,69). In a case control study nested within a follow up study, HIV- positive IV drug users with wasting (more than 10% loss of weight from baseline to last visit before death; mean follow-up, 2.4 years) had an approximately 8 fold higher risk of mortality compared with controls, after adjusting for CD4 cell counts (48,55)."

Anti wasting therapies including: anti oxidants, NAC, Cystein rich undenurtured whey proteins, combination of L-Glutamine, metobolite of amino acid leucine HMB, L-Arginine, Omega mixtures. (101)

"Nutritional problems have been a part of the clinical aspects of AIDS from its earliest recognition as a new disease" (37, 41). "In fact, in many AIDS patients, death seams to be determined more by the individualÕs nutritional status than by any particular opportunistic infection. This is, when wasting of lean body mass approaches 55% of normal for age, sex, and height, death is imminent regardless of the forces resulting is such profound malnutrition" (37, 41). Furthermore, the severity of the clinical manifestations of AIDS is proportional to the degree of the nutritional deficiencies (44-47)."(20).


19e.The New England Journal of Medicine. Volume 351:23-32 July 1, 2004 Number 1 A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality Wafaie W. Fawzi, M.B., B.S., Dr.P.H., Gernard I. Msamanga, M.D., Sc.D., Donna Spiegelman, Sc.D., Ruilan Wei, Ph.D., Saidi Kapiga, M.D., Sc.D., Eduardo Villamor, M.D., Dr.P.H., Davis Mwakagile, M.D., M.Med., Ferdinand Mugusi, M.D., M.Med., Ellen Hertzmark, M.A., Max Essex, D.V.M., Ph.D., and David J. Hunter, M.B., B.S., Sc.D. or for more references and studies go here p?webtag=INNOCUOUS&msg=227.322

20. Nutritional therapy for the treatment and prevention of AIDS. eng/papers/NutritionalTherapy_SADC_2003.html

20b.Editorial.The New England Journal of Medicine.July 1 2004,Volume 351:78-80 Number 1.Multivitamins, Nutrition, and Antiretroviral Therapy for HIV Disease in Africa Barbara Marston, M.D., and Kevin M. De Cock, M.D. and for more related notes and references go here

26. Weight Loss as a Predictor of Survival and Disease Progression in HIV Infection. J Acquir Immune Defic Syndr 1998 May;18(1):80-85. Copyright © 1998 Lippincott Williams & Wilkins All rights reserved.

27. Antioxidant Nutrients and AIDS: Exploring the Possibilities Interview With Dr. Luc Montagnier Interviewed By Richard A. Passwater Ph.D. References: 1. M. S. Gottlieb and I. Pozalski, Morb. Mortal. Wk. Rept. CDC, 30:250-2 (June 5, 1981) 2. A. Friedman, Morb. Mortal. Wk. Rept., CDC, 30:305-8 (July 3, 1981) 3. F. Barre-Sinoussi et al., Isolation of a T-lymphotropic retrovirus from a patient at risk foracquired immune deficiency syndrome (AIDS), Science 220:868 (May 20, 1983) 4. M-L. Gougeon and L. Montagnier, Apoptosis in AIDS, Science 260:1269-70(May 28, 1993) 5. A. Blanchard and L. Montagnier, AIDS-associated mycoplasmas, Ann. Rev. Microbiol.48:687-712 (1994)

69. Res. Immunol. 1992, 143, 145-148 . Oxidative Stress, HIV and AIDS. E. Papadopulos-Eleopulos (1) V.F. Turner (2) and J.M. Papadimitriou (3). (1) Department of Medical Physics, (2) Emergency Department and (3) Department of Pathology, (University of Western Australia), Royal Perth Hospital, Wellington St., Perth 6001 (Western Australia) VIRUSMYTH HOMEPAGE

57. Blood, Vol. 91 No. 10 (May 15), 1998: pp. 3817-3824. Effect of L- Carnitine on Human Immunodeficiency Virus-1 Infection-Associated Apoptosis: A Pilot Study. By Sonia Moretti, Edoardo Alesse, Luisa Di Marzio, Francesca Zazzeroni, Barbara Ruggeri, Sonia Marcellini, Giuseppe Famularo, Seth M. Steinberg, Antonio Boschini, M. Grazia Cifone, and Claudio De Simone . Go here for link to full article with graphs: ID=184164&startcat=1&ThreadID=1092872

42. Current Opinion in Clinical Nutrition and Metabolic Care 2003; 6(1):73-78 Altered amino acid metabolism in chronic obstructive pulmonary disease: new therapeutic perspective? Mari‘lle P.K.J. Engelen; Annemie M.W.J. Schols

25. Acquired Immune Defic Syndr. 2002 Oct 1;31(2):230-6. : Weight loss and survival in HIV-positive patients in the era of highly active antiretroviral therapy.Tang AM, Forrester J, Spiegelman D, Knox TA, Tchetgen E, Gorbach SL. Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston, MA 02111, USA.

26. Weight Loss as a Predictor of Survival and Disease Progression in HIV Infection. J Acquir Immune Defic Syndr 1998 May;18(1):80-85. Copyright © 1998 Lippincott Williams & Wilkins All rights reserved.

(101)John Kirkham and James Whitehead and for Omega3 and n-3 fatty acids go here

Formula of fatty acids reverses wasting +increases "cd4" s.msnw?action=get_message&mview=0&am p;ID_Message=6193&LastModified=4675477706181856642

Competing interests: Long term survivor hiv/oxidative stress/aids member Researcher Cotinuum Magazine