TreatmentUpdate 74 - Volume 8, No 10; December 1996
Sean Hosein

Protection

To reduce damage caused by free radicals the body uses vitamins C and E, as well as the colouring beta-carotene. The body cannot make any of these nutrients. Using minerals such as copper, manganese, selenium and zinc, along with the amino acids cysteine and methionine, cells make antioxidant enzymes which protect them from the damage caused by free radicals. Under continuous attack from HIV and often suffering from reduced nutrient absorption and poor appetite, PHAs may need nutritional supplements.

Study details

Researchers in France recruited 45 HIV-infected subjects (12 females and 33 males) for their study. All subjects had less than 400 CD4+ cells and 19 had been diagnosed with AIDS. The researchers divided the subjects into the following groups:

* selenium, 14 subjects

* beta-carotene, 13 subjects

* placebo, 18 subjects

The average CD4+ cell count was 140 cells for subjects in the selenium and placebo groups, and 90 cells in the beta-carotene group. Depending on the group to which they were assigned, subjects took 250 æg of a combination of selenium and methionine; 60 mg/day of beta-carotene (equivalent to 100,000 units of vitamin A activity); or fake supplements in the placebo group. For further comparison researchers used 26 non-HIV-infected, healthy subjects.

According to the researchers, "Most [subjects] were taking [AZT], while other s were taking [ddI], [d4T], or associated treatments." The researchers told subjects to take the supplements with meals (to increase absorption). Subjects were not supposed to be taking any other supplements while in the study.

Results

At the start of the study, all HIV-infected subjects had greater than normal levels of anti-oxidant enzyme activity when compared to the non-HIV-infected subjects. This difference was statistically significant; that is, likely due to HIV infection rather than chance. This finding suggests that PHAs will have a greater need for antioxidants and the nutrients needed to make the protective enzymes.

Fake supplements

As the study progressed, subjects in the placebo group had their levels of protective enzyme activity fall. By the end of the study, this decrease was statistically significant when compared to their pre-study level.

Selenium and beta-carotene

Subjects who received supplements of selenium had significantly increased levels of some antioxidant enzymes between the 3rd and 6th months of the study. Although subjects taking beta-carotene had increased levels of these enzymes, the increase was not significant.

This study was not designed to analyse the differences in the development of life-threatening infections which occurred in the following groups:

* selenium - 4

* beta-carotene - 7

* placebo - 3

The results from this study show that supplements of a few nutrients can help strengthen the body's antioxidant defences. It is important to bear in mind that selenium is only one of many important nutrients needed by the body. A more interesting study would have tested nutritional protocols for HIV/AIDS, including those proposed by Diana Davis, Lark Lands or Chester Myers (all of which are available from CATIE).

REFERENCES:

1. Delmas-Beauvieux M-C, Peuchant E. Couchouron A, et al. The enzymatic antioxidant system in blood and glutathione status in human Immunodeficiency virus (HIV) - infected patients: effects of supplementation with selenium or beta-carotene. American Journal of Clinical Nutrition 1996;64:101-107.

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Copyright © 1996 - 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