Hepatitis C and HIV Co-infection: A Treatment Update from CATIE

The Canadian AIDS Treatment Information Exchange (CATIE) has devoted the June/July Issue 2008 of its Treatment Update to a review of recent research on Hepatitis C and HIV. Here are some of the main points:

1. Although commonly viewed as simply a liver disease, Hepatitis C in recent research is strongly linked to diabetes, pre-diabetes and insulin resistance. In fact, about one-third of people with Hep C show insulin resistance, a complication that reduces chances of recovery and may lead to additional problems. Thus, researchers “need to find ways to reverse IR [insulin resistance]. Such methods could include clinical trials of diet, exercise programs and insulin-sensitizing drugs or supplements such as chromium.”

2. The HIV medication ddI (didanosine, Videx or Videx EC) has been associated with liver disease in some cases. Researchers have speculated that ddI decreases levels of a protective compound called glutathione (GSH), which is used in the body to make enzymes that help detoxification. NAC, or N-acetyl-cysteine, has been shown to raise GSH levels in people with HIV, and so could be helpful in countering ddI-related liver problems. (However, no clinical trials have yet been conducted to assess NAC’s impact on the liver health of people with HIV taking ddI.)

Read the complete Treatment Update issue here:

CATIE Treatment Update June/July 2008

For more information on the supplements mentioned above, see the NYBC entries on

CHROMIUM

NAC or N-acetylcysteine

Or, see further entries for these two supplements on this blog.

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Lipoic Acid improves Glutathione in HIV+ People

A study by Jariwalla, et al., published in the Journal of Alternative and Complementary Medicine (2008 Nov 2;14(2):139-146) reported on the effects of using 300 mg alpha lipoic acid, three times a day (900 mg) among 33 HIV+ men and women. These individuals had viral loads greater than 10,000 copies, despite being on antiretroviral therapy (ARV). The patients were randomized to receive either alpha lipoic acid or placebo over 6 months.

The main results included not only an increase in glutathione levels over baseline that was statistically significant, and a considerably enchanced ability of white blood cells (lymphocytes) to respond to antigens. In addition, as glutathione levels were increased, the ability of cells bearing CD3 molecules to respond to antigens was also enhanced.

While the intervention did not impact CD4 counts or viral load, these improvements in overall immunity in this very vulnerable population were encouraging. Improving the functional reactivity of lymphocytes to T-cell mitogens helps to strengthen immune responses to other potentially lethal pathogens. While a small study, this is encouraging news and further studies are needed in this and in populations of HIV+ individuals at other stages of infection and responsiveness to ARV therapy.

For background information on alpha lipoic acid, see the NYBC entry:

Alpha Lipoic Acid