Improvement of immune functions in HIV infection by sulfur supplementation : Two randomized trials

• Published in: Journal of molecular medicine (Berlin, Germany) Germany), 2000, Vol.78 (1), p.55-62
• Main Authors: BREITKREUTZ, R, PITTACK, N, NEBE, C. T, SCHUSTER, D, BRUST, J, BEICHERT, M, HACK, V, DANIEL, V, EDLER, L, DRÖGE, W
• Format: Article
• Language: English
• Subjects: Acetylcysteine - administration & dosage; Acetylcysteine - therapeutic use; Acquired Immunodeficiency Syndrome - blood; Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - immunology; Acquired Immunodeficiency Syndrome - virology; Administration, Oral; Adolescent; Adult; AIDS/HIV; Antigens, CD - metabolism; Biological and medical sciences; Double-Blind Method; Female; General and cellular metabolism. Vitamins; Glutamine - blood; HIV-1; Humans; Interleukin-6 - blood; Killer Cells, Natural - metabolism; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Placebos; Serum Albumin - metabolism; T-Lymphocytes - metabolism; Thioredoxins - blood; Viral Load
• ISSN: 0946-2716; 1432-1440
• DOI: 10.1007/s001090050382

To determine the therapeutic effect of sulfur amino acid supplementation in HIV infection we randomized 40 patients with antiretroviral therapy (ART; study 1) and 29 patients without ART (study 2) to treatment for 7 months with N-acetyl-cysteine or placebo at an individually adjusted dose according to a defined scheme. The main outcome measures were the change in immunological parameters including natural killer (NK) cell and T cell functions and the viral load. Both studies showed consistently that N-acetyl-cysteine causes a marked increase in immunological functions and plasma albumin concentrations. The effect of N-acetyl-cysteine on the viral load, in contrast, was not consistent and may warrant further studies. Our findings suggest that the impairment of immunological functions in HIV+ patients results at least partly from cysteine deficiency. Because immune reconstitution is a widely accepted aim of HIV treatment, N-acetyl-cysteine treatment may be recommended for patients with and without ART. Our previous report on the massive loss of sulfur in HIV-infected subjects and the present demonstration of the immunoreconstituting effect of cysteine supplementation indicate that the HIV-induced cysteine depletion is a novel mechanism by which a virus destroys the immune defense of the host and escapes immune elimination.