The role of micronutrients and how they can be
incorporated to manage HIV encephalopathy
Effect of daily consumption of zinc fortified (LSF Zn) or non-fortified (Control) water on the occurrence of common infectious morbidities in 2-6 year old children, rural western Kenya
Table 3. Demographic characteristics and liver function profiles of study participants.
Emmanuel Takuva
Department of Chemical Pathology ,College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
INTRODUCTION
Summary of reviews conti..
HIV-1 encephalopathy is a neurological disorder seen in HIV
patients. It is a symptom complex of motor, cognitive and
behavioural features associated with HIV associated
progressive encephalopathy seen in children and AIDS
dementia complex (ADC) in adults.
DISCUSSION
Table 13 Effect of daily consumption of zinc fortified (LSF Zn)
or non-fortified (Control) water on the occurrence of common
infectious morbidities in 2-6 year old children, rural western
Kenya
Morbidity per
condition
LSF Zn group
n=88
%(n event/n
visit)
3.9 (80/2063)
Control group
n=90
%(n event/n
visit)
5.0 (103/2088)
RR (95% CI)
P value
0.78(0.59,1.04)
0.090
C old runny
nose
Cough
29.8 (615/2060) 32.9(687/2088) 0.91(0.83,0.99)
0.034
27.0 (562/2062) 29.0 (610/2089) 0.93(0.85,1.03)
0.164
Stomach pain
5.6 (116/2060)
0.70(0.56,0.89)
0.003
Fever
25.0 (520/2063) 26.0(550/2091) 0.96(0.86,1.06)
0.419
Headache
22.0 (455/2058) 23.4(489/2090) 0.94(0.84,1.06)
0.322
Sore throat
5.2 (107/2061)
0.362
Diarrhoea
7.9 (167/2091)
5.8(122/2090)
0.89(0.69,1.14)
The results indicate that the consumption of zinc and N acetyl
cysteine can have a substantial replacement to enzymes which
are deficient in a patient with HIV encephalopathy.
. These micronutrients also help to strengthen the immune
system and prevent oxidative stress damage thus reducing risk
factors which make a patient more likely to HIV encephalopathy.
Recall period was 2 days for diarrhoea only and 1 week for all other conditions
assessed. LSF-Lifestraw family filter.
Oxidative stress and use of N acetyl cysteine (NAC)as
a therapeutic approach in HIV encephalopathy
Fig1.0 Pathogenesis of HIV Encephalopathy
Neurons readily form reactive oxygen species (ROS) after
gp120 exposure, and also might be protected from
reactive oxygen species injury by antioxidant enzymes
such as Cu/Zn superoxidase dismutase (SOD1) and
glutathione peroxidase. Thus a deficiency of these
enzymes or their cofactors zinc and copper makes the
body inefficient to fight against the oxygen free radicals
and makes it more likely for the species to damage
neurons.
Low serum levels of these micronutrients and also
vitamins E,b6,b12 and C ,beta carotene ,selenium and
copper are common in HIV infected individuals
1. A pilot study has found that a supplement of NAC and the
amino acid glycine can significantly and quickly reduce
excess inflammation in a small group of HIV-positive
men. The study had only 10 participants, used very high
doses of NAC and the inflammation period lasted for two
weeks
2. In the early 1990s, researchers at Stanford University in
California conducted an eight-week randomized,
placebo-controlled study of NAC in HIV-positive people.
The dose of NAC used was about 4,400 mg daily. After
the initial eight weeks, all participants were offered NAC
for six months. Researchers collected data on the
survival of participants for several years after they
stopped using NAC. They found that this supplement
significantly increased GSH levels within CD4+ cells. The
data also suggested that people who used NAC were
twice as likely to survive over the next two years
compared to people who did not ever use NAC. At the
time of the study, ART was not available and most
participants used AZT (zidovudine, Retrovir) with or
without another nuke (nucleoside analogue).
A
B
SUMMARY OF REVIEWS
Effectiveness of zinc intake on status and morbidity
1. Mocchegiani followed 18 HIV+ patients with CD4+ of 250400/mm3 on anti-vi- ral medication (AZT alone) who were
supple- mented with 12 mg elemental zinc daily for 30
days, and found the relative risk for opportunistic infection
was significantly higher in the unsupplemented group on
AZT.
2. 13 stable HIV-infected children (six years of age) were
given oral zinc, 1.8-2.2 mg/kg/day.Prior to
supplementation,9 subjects had low serum zinc levels.
After supplementation, six of the nine had normal serum
zinc levels. After 3-4 weeks, two patients had significant
increases in CD4+ count, and clinical scores improved in
four patients.
Poster template by ResearchPosters.co.za
RESULTS
•The use of zinc fortified water contributed to dietary zinc
intake and resulted in an improvement in reported childhood
infections.
•Zinc supplementing patients reduced the relative risk of
opportunistic infection as compared to patients who were not
supplementing.
•Zinc supplements increased the levels of serum zinc levels
to patient who were Zinc deficient, lymphocyte count and it
also doubled the CD4/CD8 ratio
•Taking N acetyl cysteine supplements reduced inflammation,
increased CD4 cells and increased lifespan
CONCLUSION
Intake of micronutrients increases their bioavailability to help
strengthen the body fight against infections and reactive
oxygen species which cause HIV encephalopathy
RECOMMENDATIONS
HIV patients must consider a diet which has micronutrients
necessary to avoid a high risk of HIV encephalopathy.
REFERENCES
5. Conclusions
•Nutrients and HIV:N-Acetylcystein,Alpha-LipoicAcid,LGlutamine, and L-Carnitine by Lyn Partrick,ND,Alternative
Medicine Review,Vol 5,2000
•Oxidative Stress and Therapeutic Approaches in HIV
Dementia:Joseph Steiner, Norman Haughey,
Wenxuell,ArunVenkatesan,CarolineAnderson,RollieReid,TanyaM
alpica,ChavaPocernich,D.Allan Butterfield and
AvindraNath,Antioxidants and redox signaling,Vol 5,@Mary Ann
Liebert,Inc
•The effect of nutritional support on weight gain of HIV-infected
childrenwith prolonged diarrhea,NC Rollins ([email protected]),
J van den Broeck, G Kindra,
M Pent, T Kasambira, ML
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Acknowledgements