Researchers have found that HIV-infected subjects who consumed a broad-spectrum multivitamin containing such nutrients as N-acetyl cysteine, selenium, zinc, copper, chromium, alpha lipoic acid, B vitamins, and vitamins A, C, D and E experienced an improvement in markers of immunity.
The relationship between immune function and nutritional supplementation is well described in the medical literature. Numerous studies have reported a high prevalence of nutrient deficiencies early in the course of HIV infection. These deficiencies have been shown to be associated with more frequent opportunistic infections, faster disease progression, and a greater incidence of HIV-related mortality. Possible mechanisms include increased intracellular oxidative stress, enhanced viral replication, and a reduction in the number of circulating CD4 lymphocytes associated with nutrient deficiencies. These mechanisms, alone or in part, may contribute to the increased morbidity, more rapid disease progression, and the higher mortality seen in HIV-infected patients with nutrient deficiencies.
Several prospective, randomized clinical trials have suggested that HIV-infected patients who take multinutrient supplements have improved clinical outcomes. Consequently, researchers of the current study decided to investigate what effect a multinutrient supplement would have on HIV patients.
In the randomized, double-blind, placebo controlled trial, researchers set out to determine whether a micronutrient supplement had any effect on immunity or other metabolic or clinical factors in HIV-infected patients treated with highly active antiretroviral therapy (HAART). Researchers randomized 40 HIV-infected patients on a HAART regimen to receive micronutrients or placebo twice per day for 12 weeks. Data were collected at 4-week intervals.
At 12 weeks, the mean absolute CD4 count increased by an average of 65 cells in the multivitamin group versus a six-cell decline in the placebo group. CD4 cells are a type of white blood cell that contribute to maximizing the capabilities of immune function. As an HIV infection progresses, the performance and number of CD4 cells diminish, contributing to the symptoms complex known as AIDS. It is the drop in CD4 count that is used to stage the severity of HIV infection and the timing of treatment regimens.
In the multinutrient group, the absolute CD4 count increased by an average of 24 percent compared to a 0 percent change in the placebo group. Furthermore, neuropathy scores improved in the micronutrient group by 42 percent compared with a 33 percent improvement in the placebo group. Although this difference in neuropathy scores did not reach statistical significance, the researchers suggested that the 12-week duration of their study might not have been sufficient to produce a statistically significant change in neuropathy symptoms.
Although the researchers noted that it is not possible to determine from this study which of the micronutrients or their combination is responsible for the observed improvement in immunity, they pointed out that several of the B vitamins and vitamins C and E have previously been shown to enhance cellular immunity. Moreover, the supplements used in this study included 3 additional antioxidants (acetyl l-carnitine, N-acetyl-cysteine, and alpha lipoic acid). Each of these nutrients has individually been shown to produce positive effects in HIV-infected individuals, the researchers stated.
The researchers concluded, This study demonstrates that a micronutrient supplement administered to HIV-infected patients taking stable HAART significantly enhances CD4 lymphocyte reconstitution. Our findings support the potential for a broad-spectrum micronutrient supplement to be used as adjuvant therapy in combination with HAART to provide patients with a more robust CD4 cell rebound after initiating antiretroviral treatment. Additional research including longer-term studies addressing the mechanism of action of micronutrient supplementation is warranted.
Kaiser JD, Campa AM, Ondercin JP, Leoung GS, Pless RF, Baum MK. Micronutrient Supplementation Increases CD4 Count in HIV-Infected Individuals on Highly Active Antiretroviral Therapy: A Prospective, Double-Blinded, Placebo-Controlled Trial. J Acquir Immune Defic Syndr. August 2006;42(5):523-528.