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

J Mol Med (Berl). 2000;78(1):55-62. doi: 10.1007/s001099900073.

Abstract

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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • 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
  • Antigens, CD / metabolism
  • Double-Blind Method
  • Female
  • Glutamine / blood
  • HIV-1*
  • Humans
  • Interleukin-6 / blood
  • Killer Cells, Natural / metabolism
  • Male
  • Middle Aged
  • Placebos
  • Serum Albumin / metabolism
  • T-Lymphocytes / metabolism
  • Thioredoxins / blood
  • Viral Load

Substances

  • Antigens, CD
  • Interleukin-6
  • Placebos
  • Serum Albumin
  • Glutamine
  • Thioredoxins
  • Acetylcysteine