Canadian AIDS Treatment Information Exchange: TreatmentUpdate 47 - Volume 4, No. 7 - February 1994
Sean Hosein

People whose immune systems are weakened by chemotherapy or other conditions can develop life-threatening yeast infections. The fungus Candida albicans can often cause serious mouth/throat, vaginal and intestinal infections in people with HIV/AIDS. Although several antifungal drugs are available, patients will probably need maintenance doses for the rest of their lives. So it is not surprising that doctors are beginning to report more cases of yeast resistant to one or several antifungal drugs. In an attempt to minimize their use of antifungal drugs, some patients are changing their diet and restricting their use of sugar which they hope will discourage yeast infections. Researchers in the USA have been performing experiments on baby mice with Candida and sugar to monitor the growth of yeast.

* BABY MICE AND YEAST

The researchers used yeast grown from the spinal fluid of a man who died from an overwhelming yeast infection. This yeast was then used to infect 63 mice. Of these 63, 46 survived but only 36 were used for the experiments. The 36 mice were divided into 3 groups. In group one, 14 mice were kept for observation and comparison with the other two groups. In group two, 12 mice drank water which had the sugar substitute xylitol (a natural sweetener) added. Xylitol is not ordinarily used by Candida and unlike glucose does not help yeast grow. In group three, 10 mice drank water with added glucose. The immune systems of the mice were then damaged by injecting them with the anticancer drug Cytoxan(R)(cyclophosphamide).

* RESULTS--GROWTH OF YEAST

Yeast was detected in feces samples from all the mice approximately 16 days after they had been infected. A week later the amount of fungus in feces samples from the mice fed glucose increased to levels greater than in samples from the other mice. This increase was statistically significant, that is, not likely due to chance alone.

* RESULTS--CHEMOTHERAPY

When all of the mice were given chemotherapy to suppress their immune systems the amount of yeast rose in feces samples from the mice fed glucose. The level of yeast in fecal samples from the other two groups of mice remained "relatively stable", according to the researchers.

* RESULTS--INTESTINES

Eighty percent of mice fed glucose had detectable yeast in their intestines. In comparison, 90% of the mice fed xylitol or no sugar had either no detectable yeast or only minor outbreaks. This difference between the mice fed glucose and others fed xylitol or no sugar was highly statistically significant.

* SUMMARY

Adding glucose to the diets of baby mice clearly "stimulated the growth of [yeast] in their intestines", stated the researchers. Xylitol did not increase the growth of yeast in mice. The intestines of mice fed glucose had yeast that was able to penetrate the intestine and enter the body.

* GLUCOSE

This sugar is important in stimulating the growth of yeast. This change, stimulated by glucose, helps fungi resist attack by the immune system. In these experiments xylitol did not help the growth of yeast. The researchers warned that glucose supplements in the diet can encourage the growth of Candida. Reducing the amount of added sugars in the diets of patients with HIV/AIDS may help them avoid severe oral and intestinal yeast infections.

* SUBSTITUTES?

We have reports from several doctors and their HIV-infected patients that eating less sugar has helped reduce outbreaks of oral yeast infections. For some people simply reading the list of ingredients of the processed food they buy is a good way to begin to eat less simple sugars such as corn and maple syrup, glucose, fructose, invert sugar and sucrose. Some people use the artificial sweetener NutraSweet(R) others use barley malt extracts (which have complex carbohydrates yet still taste sweet) or concentrated apple and pear juices to sweeten the taste of baked food. Some people take a daily capsule of 'friendly' bacteria (available from the refrigerated section of health food stores) which they use to help keep the growth of yeast under control. A more detailed report on this appears in the next section.

REFERENCES:

1. Vargus SL, Patrick CC, Ayers G and Hughes WT. Modulating effect of dietary carbohydrate supplementation on Candida albicans colonization and invasion in a neutropenic mouse model. Infection and Immunity 1993;61: 619-626.

9402
CATI4703

Copyright © 1994 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284  http://www.catie.ca