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National HIV Testing Day

June 27, 2011 Written by JP       [Font too small?]

Free HIV testing is being offered throughout the United States today in commemoration of National HIV Testing Day. AIDS and HIV aren’t in the news as often as they used to be, but they’re still highly relevant health threats that directly affect an estimated 30,000,000 or more people worldwide. New data presented by the Centers for Disease Control and Prevention offers another stark reminder that AIDS and HIV are pressing issues that require ongoing attention. According to figures collected between October 2007 to September 2010, a total of 2,786,730 HIV tests were funded by the US government. Of those, 29,503 tests confirmed HIV+ results. A startling 62% of those who tested positive were completely unaware they had the illness. Other statistics indicate that up to 40% of those with HIV aren’t diagnosed at all until the virus has progressed to AIDS – a process which can take upwards of 10 years. This is a tragedy that must end and is within our grasp. (1,2,3)

There is good reason for hope in the field of integrative HIV health care. Modalities including diet, exercise, mind/body therapies and nutritional supplements have slowly, but surely, made their way into the progressive management of the human immunodeficiency virus.

It’s long been known that certain conventional HIV treatments such as antiretroviral therapy can negatively impact Vitamin D or 25(OH)D levels. What’s become clearer over the past few years is just how important a deficiency of D is in those living with this virus. The preliminary data is truly remarkable. Studies in prestigious medical journals including AIDS and PLoS One indicate that adequate to optimal Vitamin D status dramatically reduces “AIDS events” (-42%), all-cause mortality (-32%) and severe anemia (-46%). In addition, those in the highest vitamin D quintiles are afforded protection against the progression of HIV to AIDS. It is for this reason that the non-profit Vitamin D Council advises maintaining 25(OH)D levels at a minimum of 40 ng/mL. (4,5,6,7,8)

Part of the danger associated with HIV is the presence of various comorbidities including cardiovascular disease, diabetes and a combination of risk factors for both known as metabolic syndrome. Once again Vitamin D comes to the rescue. Current research suggests that higher concentrations of 25(OH)D are “positively associated with improved immune restoration after antiretroviral therapy and negatively associated with CCA IMT” or carotid intima-media thickness, an indicator of heart disease. Inadequate D levels have likewise been linked to excessive insulin output and type 2 diabetes occurrence. (9,10,11,12,13)

Yet another pitfall for those receiving HIV treatment is bone loss. Ensuring adequate Vitamin D via blood tests and supplementation, when indicated, can help offset this often reported decline in bone mineral density. While all HIV patients ought to be tested for 25(OH)D, those undergoing highly active antiretroviral therapy or HAART should be especially aware of potential deficiencies. In a recent examination, the rate of hypovitaminosis D was more than double in those treated with HAART as compared to untreated HIV patients. (14,15,16)

Mindfulness based stress reduction, a program that teaches awareness via gentle exercise, meditation and tailored instruction, has demonstrated very promising results in various populations with HIV and AIDS. The benefits noted in the scientific literature range from healthier immune status (a positive shift in CD4 counts, increased activity and number of natural killer cells) to psychological measures of quality of life (“higher positive affect”, improvements in academic performance, lowered hostility, a “reduction in avoidance”, depression and stress). This mind/body approach is well very suited to most treatment protocols in that there is little risk of interaction with commonly prescribed treatments. (17,18,19,20,21)

The intestinal mucosal immune system is a prime destination for the human immunodeficiency virus type 1. HIV-1 leads to a depletion of vital immune cells and the deterioration of the intestinal lining. Prebiotics and probiotic have long been considered natural agents that may restore a healthier balance of bacteria under these circumstances. A recent Italian study investigated the effects of two different dosages of prebiotic blends in 57 HAART-naive HIV patients. Over the course of 12 weeks, the participants were given either 15 or 30 grams of a “unique oligosaccharide mixture” or a placebo. Before and after assessments of gut microbiota and immune function were measured. The results revealed that prebiotic supplementation: a) increased the level of beneficial bacteria (bifidobacteria); b) reduced populations of pathogenic microbes (Clostridium coccoides/Eubacterium rectale cluster and C. lituseburense/C. histolyticum); c) supported immunological function as evidenced by increased natural killer cell activity and a reduction of sCD14, CD4(+) T-cell activation. (22,23,24)

Any comprehensive treatment protocol for HIV ought to take diet and food selection into account. A study appearing in the December 2009 edition of the American Journal of Clinical Nutrition offers some insight into exactly what foods may best support the overall health of those with HIV. The trial itself employed a specialized menu that was high in fiber (≥40 g/day) and omega-3 fatty acids (3 grams/day), but relatively low in total fat (25%). The nutrition plan also encouraged the avoidance of “simple sugars and carbohydrate foods low in fiber”. Additional fish oil supplements were also added to the mix at a dosage of 3 grams/day or 6 grams total/day from food and supplements. The findings of this unique intervention indicate that this combination of diet and fish oil “dramatically reduced serum triglycerides, decreased arachidonic acid in the phospholipids fraction, and appeared to decrease the de novo lipogenesis associated with metabolic syndrome”. Other trials involving fish oil interventions support the value of diets rich in marine-based, omega 3 fatty acids to protect against increased cardiovascular risk associated with HIV. (25,26,27)

Optimal Vitamin D Status May Reduce Risk of HIV to AIDS Progression

Source:  PLoS One. 2010 Jan 19;5(1):e8770. (link)

Maintaining emotional and physical strength is an essential component of thriving over the long term in HIV patients. Recent studies in old and young alike make it perfectly clear that both aerobic and resistance exercises can safely increase strength and well being in adults with HIV. Exercise not only improves mood, but also addresses some of the previously mentioned risk factors such as elevated lipids and high fasting blood sugar. However, finding the right balance of physical activity is paramount. According to one recent trial, a blend of 30 minutes of moderate-intensity, aerobic training followed by 30 minutes of moderate-intensity, resistance training may be a good starting point. This specific formula resulted in a 135% increase in human growth hormone (anabolic/muscle building) and a 34% reduction in cortisol (catabolic/promoting muscle breakdown) in a group of untrained, HIV-infected men. (28,29,30)

In closing I want to offer a word of caution: Not all alternative or complementary therapies are created equal. Every option presented today is generally considered safe, but should be discussed and evaluated with your health care team. Please note that unwelcome interactions between select natural remedies (ex. echinacea, garlic, St. John’s wort, etc.) and standard care are indeed possible. In fact, every so often rare examples of this appear in reputable medical journals, and they should not be disregarded. Potential conflicts can be avoided by seeking out evidence-based information and confirming the suitability of any alternative remedy with physicians who are on the cutting edge of medicine and wellness promotion. (31,32,33,34,35)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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Posted in Alternative Therapies, Men's Health, Women's Health

20 Comments & Updates to “National HIV Testing Day”

  1. Iggy Dalrymple Says:

    To get tested, donate blood. To improve the likeli-
    hood of having a clean partner, date a blood-donor.

    I’ve donated gallons but can no longer do so because
    I’m now taking finasteride.

  2. JP Says:

    Thanks for your comments, Iggy. A very good idea. Giving blood and getting your test results. A win-win situation.

    Be well!

    JP

  3. JP Says:

    A study illustrating the importance of regular, aerobic exercise:

    http://www.njcponline.com/article.asp?issn=1119-3077;year=2014;volume=17;issue=5;spage=543;epage=548;aulast=Ezema

    Niger J Clin Pract. 2014 Sep-Oct;17(5):543-8. doi: 10.4103/1119-3077.141414.

    Effect of aerobic exercise training on cardiovascular parameters and CD4 cell count of people living with human immunodeficiency virus/acquired immune deficiency syndrome: a randomized controlled trial.

    Ezema CI, Onwunali AA, Lamina S1, Ezugwu UA, Amaeze AA, Nwankwo MJ.

    OBJECTIVE:

    Despite the significant positive effect of Highly Active Antiretroviral Therapy on physical and psychosocial well-being of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA); decreased physical activity and its associated cardiovascular risk still pose some consequences for health and general well-being. This study investigated the effect of an 8 week aerobic exercise training on cardiovascular parameters and CD4 cell (T-cells) count of PLWHA.

    MATERIALS AND METHODS:

    This randomized controlled trial recruited 30 age matched PLWHA who were randomly assigned into exercise group (EG) ( n = 15) and control group (CG) ( n = 15) respectively. The PLWHA were patients receiving treatment in President’s Emergency Plan for AIDS relief at the HIV clinic of the University of Nigeria Teaching Hospital, Nigeria. The EG in addition to conventional therapy received moderate intensity continuous exercise training (60-79% of the maximum heart rate [max]) of between 45 and 60 min, 3 times/week for 8 weeks, while the CG received conventional therapy involving antiretroviral therapy and counseling only. Systolic blood pressure (SBP), diastolic blood pressure (DBP), maximum oxygen uptake (VO₂ max) and CD4 cell count were assessed at baseline (week 1) and week 8 respectively. Analysis of co-variance and Pearson correlation tests were used in data analysis.

    RESULTS:

    Findings of the study revealed a significant effect (ANCOVA test) of moderate intensity continuous exercise training program on, SBP, DBP, VO₂ max and CD4 cell count at P < 0.05. Changes in VO₂ max significantly correlated (Pearson correlation test) with changes in CD4 cell count ( r = 0.528) at P < 0.05.

    CONCLUSION:

    Moderate intensity aerobic exercise is an effective complementary therapy in lowering blood pressure and increasing CD4 cell count in PLWHA.

    Be well!

    JP

  4. JP Says:

    Update: More evidence supporting the role of Vitamin D in HIV …

    http://www.ncbi.nlm.nih.gov/pubmed/25706751

    PLoS One. 2015 Feb 23;10(2):e0117123.

    Vitamin D₃ Supplementation in Batswana Children and Adults with HIV: A Pilot Double Blind Randomized Controlled Trial.

    OBJECTIVES: Since vitamin D insufficiency is common worldwide in people with HIV, we explored safety and efficacy of high dose cholecalciferol (D₃) in Botswana, and evaluated potential modifiers of serum 25 hydroxy vitamin D change (Δ25D).

    DESIGN: Prospective randomized double-blind 12-week pilot trial of subjects ages 5.0-50.9 years.

    METHODS: Sixty subjects randomized within five age groups to either 4000 or 7000IU per day of D₃ and evaluated for vitamin D, parathyroid hormone, HIV, safety and growth status. Efficacy was defined as serum 25 hydroxy vitamin D (25D) ≥32ng/mL, and safety as no simultaneous elevation of serum calcium and 25D. Also assessed were HIV plasma viral RNA viral load (VL), CD4%, anti-retroviral therapy (ART) regime, and height-adjusted (HAZ), weight-adjusted (WAZ) and Body Mass Index (BMIZ) Z scores.

    RESULTS: Subjects were 50% male, age (mean±SD) 19.5±11.8 years, CD4% 31.8±10.4, with baseline VL log₁₀ range of <1.4 to 3.8 and VL detectable (>1.4) in 22%. From baseline to 12 weeks, 25D increased from 36±9ng/ml to 56±18ng/ml (p<0.0001) and 68% and 90% had 25D ≥32ng/ml, respectively (p = 0.02). Δ25D was similar by dose. No subjects had simultaneously increased serum calcium and 25D. WAZ and BMIZ improved by 12 weeks (p<0.04). HAZ and CD4% increased and VL decreased in the 7000IU/d group (p<0.04). Younger (5-13y) and older (30-50y) subjects had greater Δ25D than those 14-29y (26±17 and 28±12 vs. 11±11ng/ml, respectively, p≤0.001). Δ25D was higher with efavirenz or nevirapine compared to protease inhibitor based treatment (22±12, 27±17, vs. 13±10, respectively, p≤0.03).

    CONCLUSIONS: In a pilot study in Botswana, 12-week high dose D₃ supplementation was safe and improved vitamin D, growth and HIV status; age and ART regimen were significant effect modifiers.

    Be well!

    JP

  5. JP Says:

    Update 06/16/15:

    http://www.pnas.org/content/early/2015/06/09/1500909112.full.pdf

    High-dose vitamin D3 reduces deficiency caused by low UVB exposure and limits HIV-1 replication in urban Southern Africans

    Vitamin D deficiency is associated with HIV/AIDS progression and mortality. Seasonal decline in UVB radiation, darkly pigmented skin, low nutritional vitamin D intake, and genetic variation can increase risk of deficiency. Cape Town, South Africa, has a seasonal UVB regime and one of the world’s highest rates of HIV-1 infection, peaking in young adults. In two ethnically distinct groups of young adults in Cape Town we found high prevalence of seasonal vitamin D deficiency resulting from inadequate UVB exposure. This deficiency was associated with increased permissiveness of blood cells to HIV-1 infection which was reversed by vitamin D3 supplementation. Vitamin D may be a simple, cost-effective intervention, particularly in resource-poor settings, to reduce HIV-1 risk and disease progression.

    Be well!

    JP

  6. JP Says:

    Updated 07/25/15:

    http://www.nutritionj.com/content/14/1/70

    Nutr J. 2015 Jul 21;14(1):70.

    Impact of daily supplementation of Spirulina platensis on the immune system of naïve HIV-1 patients in Cameroon: a 12-months single blind, randomized, multicenter trial.

    BACKGROUND: Micronutrient deficiencies occur early in Human Immunodeficiency Virus (HIV) infections they have reverse effects on the nutritional status. The diet supplementation with a natural nutraceutical rich in proteins and micronutrient like Spirulina platensis, may be effective and efficient in delaying HIV disease progression by frequently reported improvement in immune response.

    METHODS: A prospective single-blind, randomized, multicenter study conducted on 320 HIV-1 ARV-naïve participants for 12 months. Participants received either S. platensis supplementation and standard care or standard care and local balanced diet without S. platenis. Selected hematological and biochemical as well as CD4 count cells, viral load copies were assessed at three separate times.

    RESULTS: Among the 169 ART-naïve participants enrolled in the study, the female was mostly represented (67.1 %). The significant increase of CD4 count cells (596.32-614.92 cells count) and significant decrease of viral load levels (74.7 × 103-30.87 × 103 copies/mL) of the patients who received a supplementation of S. platensis was found after 6 months of treatment. Haemoglobin level was also significantly higher in the same group while the fasting blood glucose concentration decreased after 12 months compared to control.

    CONCLUSION: A daily supplementation with S. platensis to diet combined with a reasonable balanced diet has significantly increased the CD4 cells and reduced the viral load after 6 months. Further studies are recommended among a large specific group of people infected by the HIV in order to investigate the mechanisms involved on the effect of S. platensis on immune system.

    Be well!

    JP

  7. JP Says:

    Updated 08/20/15:

    http://www.nutritionj.com/content/14/1/81

    Nutr J. 2015 Aug 18;14(1):81.

    Vitamin D3 supplementation in HIV infection: effectiveness and associations with antiretroviral therapy.

    BACKGROUND: HIV infection and antiretroviral therapy (ART) may create unique risk factors for vitamin D insufficiency, including alterations of vitamin D metabolism by ART. We prospectively compared demographic and clinical parameters between vitamin D sufficient and insufficient HIV-infected (HIV+) adults, and assessed changes in these parameters among insufficient participants following standardized vitamin D supplementation.

    METHODS: HIV+ adults (≥18 years old) with HIV-1 RNA <50 copies/mL on ART were enrolled. Vitamin D sufficiency and insufficiency were defined as 25-hydroxyvitamin D (25(OH)D) ≥30 or <30 ng/mL, respectively. Insufficient participants received open-label vitamin D3 50,000 IU twice weekly for 5 weeks, then 8000 IU twice weekly to complete 24 weeks. The primary endpoint was success or failure to achieve 25(OH)D ≥30 ng/mL at week 24.

    RESULTS: Ninety-seven participants enrolled (34 vitamin D sufficient, 63 insufficient); 32 % female, 47 % non-White, median age 46 years, ART duration 5 years, CD4+ T lymphocyte count (CD4) 673 cells/mm(3). 25(OH)D repletion was 83 % (95 % CI 71 %-90 %) successful. 25(OH)D levels correlated with both CD4 (r = 0.44, p = 0.01) and time on protease inhibitor (r = -0.35, p = 0.01). After adjusting for age, sex, race, nadir CD4 and baseline 25(OH)D: 1) current use of efavirenz exposure was associated with a 21.1 ng/mL higher week 24 25(OH)D level (p = 0.007), 2) per year use of zidovudine was associated with 7.1 ng/mL reduction in week 24 serum 25(OH)D (p = 0.05) and 3) every 1 ng/mL 25(OH)D increase was associated with a 3.3 cell/mm(3) CD4 increase (p = 0.06).

    CONCLUSION: Vitamin D3 supplementation was effective in repleting 25(OH)D levels after 24 weeks. Current efavirenz use was positively associated with post-repletion 25(OH)D levels, while greater time on zidovudine was associated with lower post-repletion 25(OH)D levels. The association between improved CD4 recovery and vitamin D repletion suggests a potential benefit of vitamin D supplementation on immunologic recovery during HIV treatment.

    Be well!

    JP

  8. JP Says:

    Updated 08/29/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26280823

    Med Sci Monit. 2015 Aug 16;21:2406-13.

    Effect of Extra Virgin Olive Oil on Biomarkers of Inflammation in HIV-Infected Patients: A Randomized, Crossover, Controlled Clinical Trial.

    BACKGROUND: Premature atherosclerosis in HIV-infected patients is associated with chronic infection by itself and adverse effects of antiretroviral treatment (ART). Extra virgin olive oil (EVOO) has a beneficial effect on the cardiovascular system because of its anti-inflammatory properties. The objective of this study was to determine whether the consumption of EVOO improves inflammation and atherosclerosis biomarkers in HIV-infected patients receiving ART.

    MATERIAL AND METHODS: This randomized, crossover, controlled trial included 39 HIV-positive male participants who consumed 50 mL of EVOO or refined olive oil (ROO) daily. Four participants dropped out of the study. Leukocyte count, erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hsCRP), interleukin-6, fibrinogen, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, malondialdehyde, glutathione-peroxidase, superoxide dismutase, oxidized LDL and von Willebrand factor were determined before the first and after each of the 2 intervention periods. Intervention and washout periods lasted for 20 and 14 days, respectively.

    RESULTS: In participants with >90% compliance (N=30), hsCRP concentrations were lower after EVOO intervention (geometric mean [GM], 1.70 mg/L; 95% confidence interval [CI], 1.15-2.52) compared to ROO administration (GM, 2.92 mg/L; 95% CI, 1.95-4.37) (p=0.035). In participants using lopinavir/ritonavir, ESR and hsCRP concentrations decreased 62% and 151%, respectively, after EVOO administration. In the whole study population (N=35) we found no difference in analyzed biomarkers after EVOO administration.

    CONCLUSIONS: Our exploratory study suggests that EVOO consumption could lower hsCRP in patients on ART.

    Be well!

    JP

  9. JP Says:

    Updated 09/19/15:

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137200

    PLoS One. 2015 Sep 16;10(9):e0137200.

    Probiotics Reduce Inflammation in Antiretroviral Treated, HIV-Infected Individuals: Results of the “Probio-HIV” Clinical Trial.

    BACKGROUND: HIV infection results in damage to the gastrointestinal (GI) tract, microbial translocation and immune activation. These are not completely normalized with combined antiretroviral therapy (cART). Moreover, increate morbidity and mortality of cART-treated HIV-infected individuals is associated with inflammation.

    METHODS: In order to enhance GI tract immunity, we recruited and treated 20 HIV-infected humans with cART supplemented with probiotics and followed inflammation and immunological parameters (clinical trial number NCT02164344). 11 HIV seronegative subjects were included as control group. The enumeration of CD4+, CD8+, CD38+ and HLA-DR+ lymphocytes were evaluated on peripheral blood; HIV-RNA levels, sCD14, d-dimer, C-reactive protein (CRP) high sensitivity C-reactive protein (hsCRP), IL-6 and Lipopolysaccharide Binding Protein (LBP) were assayed on plasma.

    RESULTS: We observe that cART does not normalize the levels of immune activation in HIV positive patients anyway inflammation and markers of microbial translocation were significantly reduced with probiotic supplementation. Patients show a clear and statistically significant reduction in the levels of immune activation on CD4 T-lymphocytes, for both markers CD38 and HLA-DR and their simultaneous expression, LBP and hsCRP plasma levels after probiotic diet supplementation settling to values comparable to controls.

    CONCLUSIONS: Supplementing cART with probiotics in HIV-infected individuals may improve GI tract immunity and there by mitigate inflammatory sequelae, ultimately improving prognosis.

    Be well!

    JP

  10. JP Says:

    Updated 10/27/15:

    http://link.springer.com/article/10.1007%2Fs12011-015-0520-3

    Biol Trace Elem Res. 2015 Oct 1.

    Serum Zinc Concentration and C-Reactive Protein in Individuals with Human Immunodeficiency Virus Infection: the Positive Living with HIV (POLH) Study.

    Low zinc levels and chronic inflammation are common in individuals infected with human immunodeficiency virus (HIV). Zinc deficiency may promote systemic inflammation, but research on the role of zinc in inflammation among HIV-positive individuals taking account of anti-retroviral therapy is lacking. We assessed the association between serum zinc and C-reactive protein (CRP) concentration in a cohort of HIV-positive individuals. A cross-sectional survey was conducted among 311 HIV-positive individuals (177 men and 134 women) aged 18-60 years residing in Kathmandu, Nepal. High-sensitive or regular serum CRP concentrations were measured by the latex agglutination nephelometry or turbidimetric method, and zinc concentrations were measured by the atomic absorption method. Relationships were assessed using multiple linear regression analysis. The geometric means of zinc in men and women were 73.83 and 71.93 ug/dL, respectively, and of CRP were 1.64 and 0.96 mg/L, respectively. Mean serum CRP concentration was significantly decreased with increasing serum zinc concentration across zinc tertiles (P for trend = 0.010), with mean serum CRP concentration in the highest tertile of serum zinc concentration was 44.2 % lower than that in the lowest tertile. The mean serum CRP concentrations in men and women in the highest tertile of serum zinc concentrations were 30 and 35.9 % lower, respectively, than that in the lowest tertile (P for trend = 0.263 and 0.162, respectively). We found a significant inverse relation between log zinc and log CRP concentrations (beta for 1 unit change in log zinc; β = -1.79, p = 0.0003). Serum zinc concentration may be inversely associated with serum CRP concentration in HIV-positive individuals.

    Be well!

    JP

  11. JP Says:

    Updated 02/23/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728960/

    Int J Yoga. 2016 Jan-Jun;9(1):57-61.

    Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study.

    BACKGROUND: Human immunodeficiency virus (HIV) infected individuals frequently suffer from anxiety and depression. Depression has been associated with rapid decline in CD4 counts and worsened treatment outcomes in HIV-infected patients. Yoga has been used to reduce psychopathology and improve immunity.

    AIM: To study the effect of 1-month integrated yoga (IY) intervention on anxiety, depression, and CD4 counts in patients suffering from HIV-1 infection.

    METHODS: Forty four HIV-1 infected individuals from two HIV rehabilitation centers of Manipur State of India were randomized into two groups: Yoga (n = 22; 12 males) and control (n = 22; 14 males). Yoga group received IY intervention, which included physical postures (asanas), breathing practices (pranayama), relaxation techniques, and meditation. IY sessions were given 60 min/day, 6 days a week for 1 month. Control group followed daily routine during this period. All patients were on anti-retroviral therapy (ART) and dosages were kept stable during the study. There was no significant difference in age, gender, education, CD4 counts, and ART status between the two groups. Hospital anxiety and depression scale was used to assess anxiety and depression, CD4 counts were measured by flow cytometry before and after intervention. Analysis of variance – repeated measures was applied to analyze the data using SPSS version 10.

    RESULTS: Within group comparison showed a significant reduction in depression scores (F [1, 21] =4.19, P < 0.05) and non-significant reduction in anxiety scores along with non significant increment in CD4 counts in the yoga group. In the control group, there was a non-significant increase in anxiety and depression scores and reduction in CD4 counts. Between-group comparison revealed a significant reduction in depression scores (F [1, 21] =5.64, P < 0.05) and significant increase in CD4 counts (F [1, 21] =5.35, P < 0.05) in the yoga group as compared to the control.

    CONCLUSION: One month practice of IY may reduce depression and improve immunity in HIV-1 infected adults.

    Be well!

    JP

  12. JP Says:

    Updated 05/31/16:

    http://www.mdpi.com/2072-6643/8/5/132/htm

    Nutrients 2016, 8(5), 132

    Effect of Chocolate and Yerba Mate Phenolic Compounds on Inflammatory and Oxidative Biomarkers in HIV/AIDS Individuals

    Flavonoids in cocoa and yerba mate have a beneficial role on inflammation and oxidative disorders. Their effect on HIV individuals has not been studied yet, despite the high cardiovascular risk of this population. This study investigated the role of cocoa and yerba mate consumption on oxidative and inflammatory biomarkers in HIV+ individuals. A cross-over, placebo-controlled, double-blind, randomized clinical trial was conducted in 92 individuals on antiretroviral therapy for at least six months and at viral suppression. Participants were randomized to receive either 65 g of chocolate or chocolate-placebo or 3 g of yerba mate or mate-placebo for 15 days each, alternating by a washout period of 15 days. At baseline, and at the end of each intervention regimen, data regarding anthropometry, inflammatory, oxidative and immunological parameters were collected. High-sensitivity C-reactive protein, fibrinogen, lipid profile, white blood cell profile and thiobarbituric acid reactive substances were assessed. There was a difference between mean concentrations of HDL-c (ANOVA; p ≤ 0.05) among the different regimens: dark chocolate, chocolate-placebo, yerba mate and mate-placebo. When a paired Student t-test was used for comparisons between mean HDL-c at baseline and after each regimen, the mean concentration of HDL-c was higher after supplementation with dark chocolate (p = 0.008).

    Be well!

    JP

  13. JP Says:

    Updated 06/26/16:

    http://aop.sagepub.com/content/early/2016/06/17/1060028016656017.abstract

    Ann Pharmacother. 2016 Jun 20.

    Effect of Omega-3 Fatty Acids on Depressive Symptoms in HIV-Positive Individuals: A Randomized, Placebo-Controlled Clinical Trial.

    BACKGROUND: The antidepressant effect of omega-3 fatty acids has been described in the non-HIV population. The effect of omega-3 fatty acid supplementation on the mood status of HIV-positive patients has not been evaluated yet.

    OBJECTIVE: In this study, the effect of omega-3 fatty acids on depressive symptoms was evaluated in HIV-positive individuals.

    METHOD: A total of 100 HIV-positive patients with Beck Depression Score ≥16, were assigned to receive either omega-3 fatty acids or placebo twice daily for 8 weeks. Depressive symptoms of each participant were evaluated at baseline (month 0) and at the end of months 1 and 2 of the study. Beck Depression Inventory Second Edition, depression subscale of the Hospital Anxiety and Depression Scale, and Patient Health Questionnaire were used for assessment of depressive symptoms.

    RESULTS: Reduction in mean ± SD of all depression scores during the study period was statistically significant within the omega-3 group and when compared with the placebo group (for both comparisons, P < 0.001). Also, the mean differences of all depression scores were decreased significantly during the intervals: months 0, 1, and 2 (P < 0.001 for all comparisons). Among the participants, 7 (7%) and 4 (4%) patients in the omega-3 and the placebo group, respectively, experienced mild gastrointestinal problems, but the incidence of adverse drug reactions related to the interventions was not statistically different between the groups (P = 0.09).

    CONCLUSION: Omega-3 fatty acids improved depressive symptoms in HIV-positive individuals without any significant adverse reaction.

    Be well!

    JP

  14. JP Says:

    Updated 07/29/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898103/

    J Neurosci Rural Pract. 2016 Jul-Sep;7(3):362-7.

    Effect of Vitamin B12 and folic acid supplementation on neuropsychiatric symptoms and immune response in HIV-positive patients.

    BACKGROUND: Micronutrients such as B12 and folic acid deficiencies are found in higher number in HIV-infected patients.

    OBJECTIVE:We conducted a study to examine the effect of Vitamin B12 and folic acid supplementation on neuropsychiatric manifestations, CD4 count, and anthropometric measurements in HIV-positive patients.

    MATERIALS AND METHODS: Three different groups of HIV patients, namely, HIV patients with tuberculosis, HIV patients with neuropsychiatric manifestations, and asymptomatic HIV patients with 50 patients in each group were included in the study. Baseline and follow-up CD4 count, anthropometric measurements, neuropsychiatric assessments, Vitamin B12, and folic acid estimation were done.

    RESULTS: The prevalence of folic acid deficiency was 27.1% in Group I, 31.9% in Group II, and 23.4% in Group III. The prevalence of Vitamin B12 deficiency was 8.16% in Group I, 6.12% in Group II, and 4.16% in Group III. HIV patients with neuropsychiatric manifestations were noted to have the lowest mean mini-mental score. After the supplementation of vitamins, anthropometric measurements, MMSE as well as Hamilton depression scores, improved in all the three groups whereas Hamilton anxiety scores improved only in Group III. The CD4 count also improved in Groups I and II after the supplementation of vitamins.

    CONCLUSION: Folic acid deficiency was highest among neuropsychiatric patients. The majority of people who had a folic acid deficiency have shown improvement in their neuropsychiatric assessment scores as well as CD4 count after its supplementation.

    Be well!

    JP

  15. JP Says:

    Updated 10/11/16:

    http://www.mdpi.com/2072-6643/8/10/598/htm

    Nutrients 2016, 8(10), 598

    The Effectiveness of a Bioactive Food Compound in the Lipid Control of Individuals with HIV/AIDS

    Cardiovascular events due to decompensated lipid metabolism are commonly found in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) patients using anti-retroviral therapy (HAART). Thus, the aim of this study was to identify the effect of a bioactive food compound (BFC) containing functional foods on individuals with HIV undergoing HAART. Particularly, this study aims to verify the clinical outcome in the change of the lipid profile due to the use of this compound. This study includes 115 individuals with HIV on HAART. All patients received dietary guidelines; however, sixty-one consumed BFC while fifty-one did not (NO BFC). Biochemical examinations and socio-demographic and clinical profiles were evaluated. As result, in patients using hypolipidemic and/or hypoglycemic drugs, there was 28.6% decrease in triglyceride levels (p < 0.001) in the NO BFC group, and 18.3% reduction in low density lipoprotein cholesterol (LDL-C) (p < 0.001) in the BFC group. In patients who did not use hypolipidemic and/or hypoglycemic drugs in the NO BFC group, there was 30.6% increase in triglycerides, 11.3% total cholesterol and 15.3% LDL-C levels (p < 0.001) while for the BFC group there was 4.5% reduction in total cholesterol (p < 0.001). In conclusion, this study evidenced that the dietary intervention containing BFC positively affected in lipid control, since these HIV/AIDS patients using HAART are more vulnerable to lipid disorders.

    Be well!

    JP

  16. JP Says:

    Updated 12/1/16:

    http://www.mdpi.com/2072-6643/8/10/598/htm

    Nutrients. 2016 Oct 8;8(10).

    The Effectiveness of a Bioactive Food Compound in the Lipid Control of Individuals with HIV/AIDS.

    Cardiovascular events due to decompensated lipid metabolism are commonly found in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) patients using anti-retroviral therapy (HAART). Thus, the aim of this study was to identify the effect of a bioactive food compound (BFC) containing functional foods on individuals with HIV undergoing HAART. Particularly, this study aims to verify the clinical outcome in the change of the lipid profile due to the use of this compound. This study includes 115 individuals with HIV on HAART. All patients received dietary guidelines; however, sixty-one consumed BFC while fifty-one did not (NO BFC). Biochemical examinations and socio-demographic and clinical profiles were evaluated. As result, in patients using hypolipidemic and/or hypoglycemic drugs, there was 28.6% decrease in triglyceride levels (p < 0.001) in the NO BFC group, and 18.3% reduction in low density lipoprotein cholesterol (LDL-C) (p < 0.001) in the BFC group. In patients who did not use hypolipidemic and/or hypoglycemic drugs in the NO BFC group, there was 30.6% increase in triglycerides, 11.3% total cholesterol and 15.3% LDL-C levels (p < 0.001) while for the BFC group there was 4.5% reduction in total cholesterol (p < 0.001). In conclusion, this study evidenced that the dietary intervention containing BFC positively affected in lipid control, since these HIV/AIDS patients using HAART are more vulnerable to lipid disorders.

    Be well!

    JP

  17. JP Says:

    Updated 01/10/17:

    https://www.ncbi.nlm.nih.gov/pubmed/28067535

    AIDS Res Hum Retroviruses. 2017 Jan 9.

    Long-term survival of AIDS patients treated with only traditional Chinese medicine.

    Traditional Chinese herbal medicine (TCM) has been used in Chinese society for more than 5,000 years to treat diseases from inflammation to cancer. Here, we report the case of nine living AIDS patients in the age range of 51 to 67 who were treated with either a unique formula of TCM alone from 2001 to 2009 or the TCM from 2001 to 2006 and then switched to occasional antiretroviral therapy. Surprisingly, the viral loads of eight patients were at undetectable levels on June 28, 2016 while the remaining patient had a low viral load of 29 copies/ml. The CD4+ counts (170 to 592 cells/μl) and CD4+/CD8+ ratios (0.21 to 0.90) of the nine patients are excellent, contributing to their current good health. Thus, the case study suggests that the TCM has the potential to become a cure for HIV infection.

    Be well!

    JP

  18. JP Says:

    Updated 05/09/17:

    http://www.ginsengres.com/article/S1226-8453(16)30159-2/fulltext

    J Ginseng Res. 2017 Apr;41(2):222-226.

    Effect of Korean Red Ginseng intake on the survival duration of human immunodeficiency virus type 1 patients.

    BACKGROUND: Long-term ginseng intake can increase longevity in healthy individuals. Here, we examined if long-term treatment with Panax ginseng Meyer (Korean Red Ginseng, KRG) can also enhance survival duration (SD) in patients with human immunodeficiency virus type 1 (HIV-1) infection.

    METHODS: We retrospectively analyzed 252 HIV-1 patients diagnosed from 1986 to 2013 prior to the initiation of antiretroviral therapy. Overall, 162 patients were treated with KRG (3,947 ± 4,943 g) for 86 ± 63 mo. The effects of KRG on SD were analyzed according to the KRG intake level and the length of the follow-up period.

    RESULTS: There were significant correlations between the total amount of KRG and SD in the KRG intake group (r = 0.64, p < 0.0001) as well as between total amount of KRG and mean annual decrease in CD4+ T-cell count in all 252 patients (r = -0.17, p < 0.01). The annual decrease in CD4+ T-cell count (change in cells/μL) was significantly slower in KRG-treated patients than in patients receiving no KRG (48 ± 40 vs. 106 ± 162; p < 0.001). The SD (in months) was also significantly longer in the KRG group than in the no-KRG group (101 ± 64 vs. 59 ± 40, p < 0.01).

    CONCLUSION: KRG prolongs survival in HIV-1 patients, possibly by slowing the decrease in CD4+ T-cell count.

    Be well!

    JP

  19. JP Says:

    Updated 10/20/17:

    http://www.mdpi.com/1422-0067/18/10/2185/htm

    Int J Mol Sci. 2017 Oct 19;18(10).

    Effects of Short-Term Probiotic Ingestion on Immune Profiles and Microbial Translocation among HIV-1-Infected Vietnamese Children.

    Here, we investigated the effects of the probiotic strain Lactobacillus casei Shirota (LcS) on immune profiles and intestinal microbial translocation among children infected with human immunodeficiency virus (HIV). This prospective study included 60 HIV-infected children-including 31 without antiretroviral therapy (ART) (HIV(+)) and 29 who received ART for a median of 3.5 years (ART(+)) and 20 children without HIV infection (HIV(-)). Participants were recruited in Vietnam. All children were given fermented milk containing LcS (6.5 × 10⁸ cfu) daily for 8 weeks. Before and after LcS ingestion, blood samples were collected for virological, immunological, and bacteriological analyses. After LcS ingestion, peripheral CD4⁺ T-cell and Th2 (CXCR3-CCR6-CD4⁺) counts significantly increased in both HIV-infected groups; Th17 (CXCR3-CCR6⁺CD4⁺) counts increased in all three groups; regulatory T-cell (CD25highCD4⁺) counts decreased in the ART(+) and HIV(-) groups; activated CD8⁺ cells (CD38⁺HLA-DR⁺CD8⁺) decreased from 27.5% to 13.2% (p < 0.001) in HIV(+) children; and plasma HIV load decreased slightly but significantly among HIV(+) children. No group showed a significantly altered frequency of bacterial 16S/23S rRNA gene detection in the plasma. No serious adverse events occurred. These findings suggest that short-term LcS ingestion is a safe supportive approach with immunological and virological benefits in HIV-infected children.

    Be well!

    JP

  20. JP Says:

    Updated 12/1/17:

    http://www.nutritionjrnl.com/article/S0899-9007(17)30128-4/fulltext

    Nutrition. 2017 Nov – Dec;43-44:61-68.

    Effect of chocolate and mate tea on the lipid profile of individuals with HIV/AIDS on antiretroviral therapy: A clinical trial.

    OBJECTIVE: HIV/AIDS is generally associated with dyslipidemia and oxidative imbalance, which are caused by the infection itself and by antiretroviral therapy (ART). The flavonoids, found in cocoa and yerba mate, have antioxidant and hypolipidemic properties. The aim of this study was to evaluate the effects of the consumption of dark chocolate and mate tea on the lipid profiles of individuals with HIV/AIDS who are undergoing ART.

    METHODS: A randomized, double-blind, placebo-controlled crossover clinical trial was conducted with 92 patients receiving ART for ≥6 mo and with viral suppression. The participants were randomized to receive either 65 g of chocolate (with 2148 mg polyphenols) or placebo chocolate (without polyphenols) or 3 g of mate tea (with 107 mg total phenols and 84.24 mg chlorogenic acid) or placebo mate (without polyphenols) for 15 d each, separated by a washout period of 15 d. The lipid profile, including determination of electronegative low-density lipoprotein, was determined after each intervention. The data were analyzed by analysis of variance using the pkcross procedure of the Stata 11.0 software.

    RESULTS: Analysis of variance revealed a significant overall difference in mean high-density lipoprotein cholesterol (HDL-C) between all supplements (P = 0.047). Using the paired t test, the effect was attributed to the consumption of dark chocolate (P = 0.046). The other parameters investigated were not improved.

    CONCLUSIONS: The consumption of dark chocolate for 15 d improved HDL-C concentrations of individuals with HIV/AIDS undergoing ART, possibly due to the presence of fatty acids (stearic acid), polyphenols, and theobromine. This fact is important for the cardiovascular protection of these individuals.

    Be well!

    JP

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