Important note: Information in this article was accurate in December 2000. The state of the art may have changed since the publication date.
Researchers in Heidelberg, Germany, conducted two seven-month studies of supplementary cysteine taken in the form of NAC (N-acetyl-cysteine) in subjects with symptom-free HIV infection. Subjects had between 200 and 500 CD4+ cells and none had liver damage or abused alcohol or other drugs. In the first study, researchers analysed the effect of NAC compared to placebo in 37 subjects (16 female, 21 male) who were also taking anti-HIV therapy. Three subjects were taking single-nuke anti-HIV therapy, 60% were taking double-nuke therapy and the remaining subjects took HAART. Researchers randomly assigned subjects to receive either NAC or placebo. The basic lab values for these two groups of subjects (NAC group or placebo group) were as follows:
The difference in the average viral load between the two groups was not significant.
In the second study, researchers examined the effect of NAC on 29 subjects (13 female, 16 male) who were not taking anti-HIV therapy. Again, researchers randomly assigned subjects to receive NAC or placebo and the basic lab values were as follows:
Again, these differences were not significant.
Subjects received NAC or placebo every other day for seven months. The dose of NAC that subjects received ranged between 600 mg to 3,600 mg every other day. Several weeks after the study began, the dose of NAC was adjusted depending on the level of the amino acid glutamine in the blood. The reason for this decision, according to the researchers, is that too much NAC can raise levels of the amino acid glutamine in the blood to higher-than-normal levels. On average, subjects received about 3 grams of NAC every other day.
The use of NAC clearly improved the functioning of a group of cells called NK, or natural killer cells. This change was seen in both studies. NK cells play an important role in fighting viruses and tumours. The functioning of these cells increased to "almost normal levels," according to the researchers.
Levels of CD4+ and CD8+ cells did not change significantly in either study group. In one of the studies, use of NAC was linked to reduced production of inflammatory chemicals by the body. Overall, the researchers do not think that NAC helped to suppress viral load during the study.
Compared to subjects on placebo, subjects who received NAC had increased levels of the following nutrients in their blood:
This increase in albumin is important. Low levels of albumin suggest that the body is not getting enough protein to meet its needs. As a result, the body begins to tear down muscle to meet its protein requirements. As well, low levels of albumin have been linked to reduced chances of survival in PHAs. Therefore, these changes seen with NAC supplementation are beneficial.
The results from these two studies show that NAC supplements clearly help the immune system, regardless of whether or not subjects used HAART. The supplements also reversed the loss of cysteine seen in PHAs. Long-term use of NAC may help prolong survival by helping to maintain cysteine and protein levels. At an average dose of 3 grams every other day, NAC was not associated with any toxicity. It is important to note that absorption of NAC in people is increased when it is taken with acidic fluids such as cola drinks or fruit juice.
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