TreatmentUpdate80 - Vol. 8, No. 0; August 1997
Sean Hosein

One problem arising from HIV infection is that the insulation covering nerve fibres can become damaged. The information being sent along these nerves then leaks and does not arrive intact. In some people this is linked with problems with memory. Treating the 'insulation' damage may correct the HIV-associated memory problems. Use of the amino acid methionine seems to help improve memory of some PHAs in one small study. There are some important issues to take into account before starting a regimen of methionine.

Study details and results

Doctors recruited 12 HIV-infected subjects for a 6 month study of oral methionine at a dose of 6 grams/day. At the start of the study 7 subjects underwent [neuropsychological] testing to assess any brain damage due to HIV infection. Researchers found that 5 of the 7 had some form of minor brain damage. Four of the 5 improved by the end of the study while the other did not get worse. The remaining 2 subjects did not develop any detectable brain damage. Presumably the subjects who did not undergo neuropsychological testing did not have any obvious brain damage. A double-blind, placebo-controlled study of oral methionine is underway in New York to test the effect of this nutrient on HIV-related memory and thinking problems.

Healthy nerves depend on the B vitamin choline (found in lecithin), methionine (eggs and other protein rich food) and other substances for compounds called methyl groups. Vitamins B12 and "at least B6 and magnesium" are also needed for enzymes involved in the supply of methyl groups. Unfortunately, low levels of these nutrients have been noted in PHAs. These low levels may also play a role in some of the memory and thinking problems associated with HIV infection. Supplying extra methionine when levels of B vitamins and magnesium are low may only improve symptoms without dealing with the underlying problem. Deficiencies of vitamin B12 that are not corrected can lead to serious damage. To keep the supply of methionine from being used up, supplements of NAC (N-acetyl-cysteine) could be taken since the body converts methionine into cysteine. Although this also does not correct the underlying problem, it may be safer than taking methionine. For further information on these nutrients, please read brochures produced by Lark Lands, Jennifer Jensen and Chester Myers, available from CATIE.

REFERENCES:

1. Dorfman d, DiRocco A, Simpson D, et al. Oral methionine may improve neuropsychological function in patients with AIDS myelopathy: results of an open-label trial. AIDS 1997;11(8):1066-1067.

2. Myers CD. Methylation, B12, B6, magnesium, NAC and methionine (written communication). July 1997.

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Copyright © 1997 - 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