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HIV and Nutritional Supplementation

Nutrition for HIV
Nutrition for HIV
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Larisa Klein

From the flu to HIV, viruses have plagued human kind since the beginning of time. They are unable to replicate on their own but can do so once inside a living host. This puts them in a grey area between what we consider living and non-living things. Our lack of understanding of what they are and how they work, have made it difficult to find cures for most viral conditions. For example, scientists have been unsuccessfully seeking a cure for HIV since it first showed up in the 1980’s. Luckily, nature has provided us with substances which can fight the virus and its deleterious effects.

Viruses contain DNA or RNA. They enter a cell and give its nucleus its own viral information which the cell then multiplies. The new viruses rupture the cell, invade more cells, and continue to replicate themselves. A virus may or may not have a membrane or envelope. If it is not enveloped, it doesn't have a protective membrane and is more easily recognized and destroyed by the body. These types of viruses enter the cell via proteins which slash through cellular membranes, opening up a way for them to get to the nucleus. (Herbert, 2007)

Enveloped retroviruses such as HIV, Ebola, and rabies, use a different process to multiply. Before they become infectious, they “pinch off” a cell membrane via a process called budding. A specific protein called Gag (groups specific antigen) contains the code that produces these buds. An additional protein, ubiquitin ligase, encourages the virus to assemble to the bud. In this final step the virus becomes infectious. Understanding this mechanism could ultimately lead to the development of one antiviral drug which could be applied to a wide spectrum of viruses. This would be similar to how one antibacterial drug can be successfully used against many types of bacterial infections. (Patnaik, 2000)

There are three major stages between infection and AIDS. During the acute infection stage, large amounts of the virus are being produced. The individual usually feels very ill during this stage. The clinical latency stage is characterized by a drop of viral load and lack of symptoms. Without medication, the individual can live in this latent phase for as long as ten years. AIDS begins when CD4+ cell counts drop below 200 cells per cubic millimeter. One may live up to three years without medication during this stage. (Aids.gov, 2013)

HIV destructs the immune system which leads to complications and opportunistic infections, debilitation, and eventually death. Malnutrition is a serious concern and is a prognostic indicator in the advancement of the disease. Wasting syndrome, another complication, consists of weight loss of more than 10% of body mass. Insulin sensitivity and protein turnover usually leads to loss of lean body mass, especially when energy intake is diminished as well. Other causes of weight loss include chronic diarrhea and other opportunistic infections. Levels of vitamins A, B12, selenium, and zinc are particularly associated with the progression of the disease. (Salomon, 2002)

Medication is highly effective in managing this condition. Highly active antiretroviral therapy (HAART) is associated with changes in body fat distribution and other metabolic abnormalities. Fat stores can be both depleted and accumulate in various locations on the body. For example accumulations have been especially observed in the back of the neck, above clavicle area, abdomen and breast. Abdominal obesity, high serum lipids, and insulin resistance lead to an increased risk of diabetes and arthrosclerosis. Lactic acidosis or blood that is too acidic, can also lead to hepatic failure and death. (Salomon, 2002)

Antiretroviral medications substantially increase lifespans and quality of life to people infected with this virus. They are, however, very expensive and their side effects negatively impact health and well-being. Nutrition supplementation has been shown to delay the need for medication and to improve health. Nutritional intervention is especially important early in the progression as it maximizes gain of lean body mass, supports immunity, and diminishes the effects of wasting syndrome.

One particular study tested three types of supplementation: with vitamin A alone, one with vitamins B-complex, C, E and A, and one with the same multivitamins but no vitamin A. Then disease progression was studied by noting complications, T-cell (immunity) counts, and viral load. The regimen which included no vitamin A was shown to delay progression of the disease, reduce risk of death of AIDS, significantly increased T-cell counts, and lower viral load. Supplementation which included vitamin A reduced the benefits while supplementation with vitamin A alone was not significantly different than placebo. In fact, vitamin A was withdrawn from the experiment because it increase transmission of virus from mother to baby. (Fawzy, 2004)

The benefits were most impressive in the first two years but were still observed at four years. Supplementation reduced progression to the final phase of the disease, reduced oral and gastrointestinal complications, fatigue, rash, upper respiratory infections, nausea, vomiting, and diarrhea. In addition to the apparent immunity enhancement, it is believed that multivitamins also reduce HIV replication as implied by the reduced viral load. These benefits were observed for a median of five years. (Fawzy, 2004)

Drug therapy, nutritional, and lifestyle changes can lower progression of the disease and improve quality of life for those living with HIV. Adding nutrition therapy, lipid lowering therapies, smoking cessation, exercise, and weight reduction for obesity, are all recommended in addition to antiretroviral medications to further prolong life and a sense of well-being.

References
Fawzy, W., Msamanga, G., Spiegalman, D., Wei, R., Kapiga, S., Villamor, E., Mwakagile, D.,
Mugusi, F., Hertzmarl, E., Essex, M., Hunter, D. (2004, July). A Randomized Trial of
Multivitamin Supplements and HIV Disease Progression and Mortality. The New
England Journal of Medicine. Retrieved from www.evergladeslibrary.org on 4/24/2014.
Document URL :
http://search.proquest.com.ezp-01.lirn.net/docview/223938833?accountid=1...

Hebert, D. (2007, January). University of Massachusetts Scientists Reveal a Virus’ Secret
Weapon, Sheds Light on How Brain, Kidney Viruses Infect. US Fed News Service.
Retrieved from www.evergladeslibrary.org on 4/24/2014. Document URL
http://search.proquest.com.ezp-01.lirn.net/docview/473123596?accountid=1...

Patnaik, A., Wills, J. (2005, December). Virology; Research Unravels Key Facts About How a
Virus Exits Host Cell. Virus Weekly. Retrieved from www.evergladeslibrary.org on
4/24/2014. Document URL:
http://search.proquest.com.ezp-01.lirn.net/docview/212924265?accountid=1...

Salomon, J., De Truchis, P., Melchior, J.C. (2002). Nutrition and HIV Infection. The British
Journal of Nutrition. Retrieved from www.evergladeslibrary.org on 4/24/2014. Document URL:
http://search.proquest.com.ezp-01.lirn.net/docview/ 213840002/ 9FED5C18880B4F54PQ/11?accountid=107221

Stages of HIV Infection. Retrieved on 4/24/14 from Aids.gov.