Aids

Description

Acquired immune deficiency syndrome (AIDS) is a health condition characterized by severe and irreversible damage to the immune system. This causes susceptibility to several uncommon infections, especially a rare form of pneumonia, Pneumocystis carinii, and a rare form of cancer, Kaposi's sarcoma. These organisms, which are normally controlled by the body, become deadly due to decreased function of white blood cells in the blood.

There are three stages in the disease. The first phase is the HIV infection and the extended asympotomatic incubation which occurs two to four weeks after exposure. It is characterized by a mild flu-like illness accompanied with fever and muscle aches which does not last more than a few weeks. Antibodies to the viral infection are produced, but the disease is usually asymptomatic for eight to ten years.

The second phase is the AIDS-related complex (ARC). In this stage, the opportunistic illnesses begin to occur since the virus has killed enough white blood cells, more specifically T-helper lymphocytes, for the immune function to fight back the antigens. ARC is a less severe, and less fatal form of AIDS. Estimates indicate for every confirmed AIDS patient, there are ten who suffer from ARC. The symptoms associated with ARC tend to be similar to, although less virulent than, those of AIDS. ARC is characterized by recurring symptoms such as fever, lethargy, diarrhea, lymphadenopathy, malaise, respiratory problems and a depressed immune system.

The final stage is characterized by Tuberculosis, Kaposi's Sarcoma, Pneumonia, or Lymphoma. AIDS is defined by the Center of Disease Control as T-cell of less than 200/mm3.

AIDS is caused by a retrovirus (the Human Immunedeficiency Virus or HIV) with an incubation period of seven or more years. AIDS is not believed to be generally contagious because it requires the exchange of bodily fluids and entry of the retrovirus into the recipient's bloodstream. The highest incidence is presently among homosexual males. Currently, the death rate is 70% within two years of diagnosis.

The first indication an individual has been exposed to HIV is the detection of antibodies to the HIV in the bloodstream. The presence of antibodies does not indicate an individual will contract AIDS, but their presence does indicate infection with the virus. Unlike many viruses, the HIV can be latent ("hide") for years within various body sites like the brain, bone marrow and macrophages. The HIV flourishes in a type of white blood cell called the T-helper cell. Once the HIV becomes active, it multiplies rapidly and makes thousands of new copies of itself in the T-helper cell. The virus exits the cell by through cell lysis. As the infected T-helper cells are broken apart, new HIV virus particles are released to infect other T-helper cells throughout the body.

In research studies, nutritional status as determined by albumin and percent weight loss was strongly related to survival. Immunological dysfunction, development of infectious processes, and vital organ dysfunction are related conditions to malnutrition.

The organ damage associated with the degree of malnutrition observed in AIDS patients further increase the risk of severe infection complications which are usually associated with this condition.

The rate at which albumin decreases during the course of AIDS may define a limiting function for survival of the patients with this condition. Moreover, nutritional status is strongly associated with survival in these patients.

Among the health conditions defined by the Center for Disease Control (CDC), 1987, Pneumocystis carinii pneumonia was the most common cause of death. Other conditions in the definition include: Lymphomas, Kaposi's sarcoma, cryptococcosis, mycobacterial infections, extrapulmonary tuberculosis, cytomegalovirus, HIV encephalopathy, candidiasis, and others.

Some other underlying causes of death among AIDS patients are pneumonia (other than Pnemocystis carinii), infections (not included in the definition), other immunodeficiencies, drug abuse and cancers such as lung cancer, Hodgkin's disease and lymphoid leukemia.

In January 1993, the CDC expanded the surveillance definition for AIDS in adults and adolescents, adding four new criteria in persons with documented HIV infection: a CD4 + T-lymphocyte count below 200/mcgL or percentage below 14, pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancers.

Because of cell lysis, the initial clinical manifestation of AIDS is the depression of T-helper cell activity in the body. Furthermore, infected T-helper lack the ability to aid other components of the immune system, like macrophages, in fighting infections. The AIDS patient does not die from AIDS, but from the body's inability to fight off opportunistic infections.

As of March 31, 1993, there were 289,320 AIDS cases in the United States reported to World Health Organization. The worldwide cumulative AIDS cases reported to the World Health Organization as of July 1, 1993, is 718,894. This data includes men who have sex with other men, and/or hypodermic needle drug users; hemophilia/coagulation disorder; heterosexual contacts or mother with/at risk for HIV infection (pediatric catagory); sex with injecting drug user, sex with bisexual men, sex with hemophiliac person, born in Pattern II country (Pattern II is an exposure category with a distinctive pattern of heterosexual transmission identified by the World Health Organization), sex with a person born in Pattern II country, sex with transfusion recipient with HIV infection, sex with person with HIV infection-risk not specified; recipient of blood transfusion, blood component of tissue; and other undertermined cases.

A cure is unknown; a specific prevention (i.e., a vaccine) has yet to be developed; the natural course of the disease is unknown. Treatments now available include removal of skin cancer, chemotherapy and drugs to raise the body's resistance to disease states.

Causes

Primary Factors
AIDS is primarily due to a transmittable agent. Presently there is evidence AIDS may be caused by a retrovirus of the human T-cell leukemia/ lymphoma virus (HIV) family.

Predisposed Individuals
Most cases (50.8%) reported in 1992, were attributed to HIV transmission among homosexual/bisexual males, especially those who practice rectal intercourse. However, there is a steady increase in heterosexually acquired AIDS cases among men and women. Heterosexual contact accounted for the largest proprotionate increase (17.1%) in reported cases. There was a larger proportionate increase among women (9.8%) than among men (2.5%); for women, the rates were higher for non-Hispanic blacks and Hispanics than for non-Hispanic whites; intravenous drug abusers (caused by unsterilized needles infected with the AIDS retrovirus); recipients of blood transfusions (the number of such cases is decreasing since blood donors are now screened for being high risk AIDS carriers); and infants of AIDS victims.

The increase in AIDS among women is reflected by an increase in cases among infants and children age 0-4, which had the second largest proportionate increase (perinatal transmission = 13.4%). The increase among women between the ages 20-29 years primarily reflects persons who were infected as adolescents.

In more than 60 cities in the United States, AIDS is now the leading cause of death among men between the ages of 25 and 44 years.

Signs & Symptoms

Susceptibility to opportunistic infections
Rapid swelling and soreness of neck, armpit, and groin
Swollen lymph nodes
Sudden weight loss
Chronic fatigue
Night sweats and/or low grade fever
Persistent cough
Reddish-purple bumps on the skin (symptom of Kaposi's sarcoma)
Longstanding diarrhea
Dyspnea
Malnutrition
Flu-Like illness
Low Serum Albumin

Nutritional Supplements

Structure & Function: Immune System Support

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General Supplements
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	Adult
Aloe vera*
Arginine	500 - 1,000 mg
DHEA*
Fish oils*
Lecithin*
Phosphatidylserine*
Vitamin C	1,000 - 10,000 mg
Zinc	30 - 100 mg

* Please refer to the respective topic for specific nutrient amounts.

Notes:

In desperation, there are few supplements, or drugs, that HIV/AIDS patients have not tried. It is not possible to list everything, especially on purely anecdotal evidence.

Several natural products e.g. Aloe Vera, Bee Propolis and Chlorophyll may be mentioned although the definitive studies have not been completed. A derivative from aloe vera looks particularly promising.

One manufactured hormone: DHEA has become very popular, since it can support so many different hormones.

Another breakthrough line of products derives from lecithin. It may be derived directly, from eggs or soy, as lecithin, or be sold in refined forms, as phosphatidyl choline or serine. The animal source (egg) has been particularly recommended for AIDS patients.

Recent interest in essential fatty acid metabolism has indicated fish oils may be useful for AIDS patients.

Of the more exotic trace minerals, Germanium is sometimes recommended (100 - 300 mg daily).


Note:

All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

The infection and fever of AIDS accelerate the metabolism and increase the body's need for protein and calories. The paradox is the loss of appetite, as well as the nausea, diarrhea and depression that accompany AIDS make it difficult for the individual to consume enough food to meet this need.

A high ratio of malnutrition is incompatible with continuation of survival. Regardless of the reason, when the lean body mass (LBM) decreases to less than 55% of normal, death is inevitable (unless treated).

Early in the course of disease, the total body water increases contrary to the depletion of LBM. This increase in extracellular fluid volume will prevent an attempt to use weight loss as an early marker of nutritional illness. There is an increase in Resting Energy Expenditure (REE), and protein-energy malnutrition (PEM) usually results. Changes in LBM, decrease in circulating levels of export proteins, and progressive weight loss are all evidence for PEM in AIDS.

A great amount of attention must be given to both dietary adequacy and the events underlying tissue cachexia. By intervening early in the course of HIV, LBM can be preserved and micronutrient deficiencies prevented. Some micronutrients, such as iron, zinc, and vitamin A, will be seizured in the intracellular compartment as they shift rapidly from plasma to tissues due to infection, stress and/or inflammation. Therefore, in the presence of acute inflammatory stimuli, it is not possible to accurately assess the nutritional status of these nutrients.

The host defense mechanisms must be mobilized during the infection, to this end an Immune Strengthening Diet may be helpful. There is an increased expenditure of amino acids, vitamins, minerals, carbohydrates and lipids to form new white blood cells, antibodies and other immune factors. The body is in a negative nitrogen balance while fighting the AIDS infection.

Antioxidants of the host cell are important in impairing HIV replication during the opportunistic infections. Vitamin C and other antioxidants apparently help in suppressing replication of HIV. Vitamin C may help by suppressing the extracellular HIV reverse transcriptase activity.

Low serum levels of Vitamin B12 has been detected in some of the patients. This deficiency may be the possible cause of some of the cognitive changes occuring in AIDS patients; therefore, regular injections of vitamin B12 may be helpful. Folate absorption may become impaired due to vitamin B12 deficiency.

Individuals often lose weight, body tone and tissue due to catabolism of protein and fat. This muscle wastage occurs when the diet does not provide enough exogenous proteins and calories for fueling the metabolic processes. A Protein Enriched Diet should be followed to aid in tissue repair and growth. In the case of a 150 pound male 3,500 calories containing 105 grams of protein may need to be consumed per day to prevent wastage and maintain weight. As many as 5,000 calories per day may be needed by some individuals.

Fever increases the body's metabolic rate 7% for every degree Fahrenheit increase or 15% for every degree centigrade. Cardiac output accelerates, accounting for the quickened pulse and flushed face. Respiratory rate also accelerates and thrashing may occur from restlessness.

These metabolic changes cause a greater caloric expenditure, and calories should be provided in the diet to avoid a negative nitrogen balance and muscle wastage. Nitrogen, potassium, magnesium, inorganic phosphorus, zinc, sulfur and sodium chloride are lost through sweat during fever. These should be replaced by eating foods high in these nutrients, or by taking supplements. Another trace mineral low in AIDS patients is selenium.

Often the infection produces a change of taste with respect to proteins. Meats are often perceived as being tasteless or having a metallic flavor. Different seasonings might help make the flavor palatable. Sometimes a switch to poultry or fish may make protein more acceptable to the individual.

Sometimes greasy or fried foods may cause nausea. They should be eliminated from the diet if they pose a problem.

Diarrhea may result from lactose intolerance or gastric irritability. A Lactose Restricted Diet or a Low Fiber Diet may correct these problems and ensure the absorption of nutrients and calories.

Dietary inadequacy may be caused by intentional changes in dietary intake (psychological), intestinal malabsorption, increased cell catabolism and reasting energy expenditure (REE), involuntary decrease in nutrient intake (anorexia), drug-nutrient interaction, and redistribution of nutrients. A cheerful eating environment may increase the appetite. The individual may benefit from eating with friends.

Homeopathic Remedy

1.* Thymus Serpyllum - 6X
2.* Spleen tinct. - 6X
3.* Echinacea angustifolia - 30X to 30C
4. Serum isode or patient - at least 30X
5. Glandula lymphatica - 6X

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency
Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Herbal Approaches

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Herbs
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Aloe vera
Chaparral
Curcumin
Red clover
Garlic Plant
Shitake mushrooms
St. John's Wort

Note: The misdirected use of an herb can produce severely adverse effects, especially when it is taken with prescription drugs or other medications.

This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.

Discussion:

A mannose derivative from Aloe vera may be a natural equivalent to AZT.

Reishi and Shitake mushrooms are good immunomodulators.

St. John's Wort is effective against retro-viruses.

Contraindications:

Although evidence is slight, it is always better to err on the side of caution.

Progressive conditions (e.g. multiple sclerosis and lupus as well as auto-immune disorders, including AIDS) are considered by some authorities to warrant a warning against the use of echinacea.

Echinacea may speed up the secretion of tumor necrosis factor, thereby speeding up the replication of HIV virus. More research is needed to ascertain whether the whole extract, or which part, has this effect and if it translates to the clinical situation.

Newall has compiled the following list of immunostimulating herbs:

Herb	Effects
Boneset	Stimulant in vitro
Calendula (Marigold)	Stimulant in vitro
Drosera (Sundew)	Stimulant &depressant (in vitro)
Echinacea	Stimulant in vitro, in vivo
Ginseng,	Stimulant, human
Eleutherococcus
Mistletoe	Stimulant, human;
	suppressant (high doses), human
Saw Palmetto	Stimulant, in vivo

References:

Blumenthal, M. German Commission E Monograph for Echinacea purperea herb. HerbalGram, 1994, 30:48.

Bodinet, C. et al: Host resistance increasing activity of root extracts from Echinacea species. Planta Med. 1993, 59(Supp): A672.

Bukovsky M et al., [Immunomodulating activity of ethanol-water extracts of the roots of Echinacea gloriosa L., Echinacea angustifolia DC. and Rudbeckia speciosa Wenderoth tested on the immune system in C57BL6 inbred mice] Cesk Farm, 1993 Aug, 42:4, 184-7.

DeSmet, P. et al. (Eds.), Adverse Effects of herbal Drugs 2. Springer Verlag, Berlin, 1994.

Lersch C et al., Nonspecific immunostimulation with low doses of cyclophosphamide (LDCY), thymostimulin, and Echinacea purpurea extracts (echinacin) in patients with far advanced colorectal cancers: preliminary results. Cancer Invest, 1992, 10:5, 343-8.

Luettig B et al., Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst, 1989 May 3, 81:9, 669-75.

Mengs U et al., Toxicity of Echinacea purpurea. Acute, subacute and genotoxicity studies. Arzneimittelforschung, 1991 Oct, 41:10, 1076-81.

Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.

Schinazi, R.F. et al. (1990) Anthaquinones as a new class of antiviral agents against human immunodeficiency virus. Antivial Res. 13:265.

See DM et al., In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients.

Steinbeck-Klose, A & Wernet, P: Successful long term treatment over 40 months on HIV-patients with intravenous Hypericin. Int. Conf AIDS, 1993, 9(1):470. (Abstract)

Wichtl, M. Herbal Drugs & Phytopharmaceuticals. CRC, Boca Raton, 1994.

Aromatherapy - Essential Oils

Lavender Essence
Vetiver Essence
Ylang-Ylang Essence

Related Health Conditions

Cancer
Diarrhea
Fatigue
Fever
Infection
Pneumonia
Lymphomas
Kaposi's Sarcoma
Cryptococcosis
Mycobacterial infections
Extrapulmonary tuberculosis
Cytomegalovirus
HIV encephalopathy
Candidiasis
Hodgkin's disease
Lymphoid luekemia

Abstracts

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