AIDS – acquired immunodeficiency syndrome – was first reported in the United States in 1981 and has since become a major worldwide epidemic. When the first AIDS cases were recognized, few would have thought that so many years would pass without a cure being discovered. There still remains speculation as to the causative agent; although the controversy continues, AIDS is commonly thought to be caused by the human immunodeficiency virus (HIV). By killing or damaging cells of the body’s immune system, HIV progressively destroys the body’s ability to fight infections and certain cancers.
By 2001, more than 750,000 cases of AIDS had been reported in the United States and as many as 1,000,000 Americans were thought to be infected with HIV – an invection rate of about 0.4%. Growing most rapidly among minority populations, it is a leading killer of African-American males. The rates of infection are very high in some southern African countries, with the situation in Botswana being described as shocking – by 2001 some 36% of the adult population was infected. South Africa came second in that region with a 20% rate.
HIV is spread most commonly by having unprotected sex with an infected partner, contact with infected blood or being born to an HIV infected mother. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV also can also be spread to babies through the breast milk of infected mothers.Studies of families of HIV-infected people have shown clearly that HIV is not spread through casual contact such as the sharing of food utensils, towels and bedding, swimming pools, telephones, or toilet seats. HIV is not spread by biting insects such as mosquitoes or bedbugs. Scientists also have found no evidence that HIV is spread through sweat, tears, urine, or feces.
Symptoms
Many people do not have any symptoms when they first become infected with HIV. Some people, however, have a flu-like illness within a month or two of being exposed to the virus. This illness may include fever, headache, tiredness or enlarged lymph nodes. These symptoms are often mistaken for those of another viral infection. During this period, people are very infectious and HIV is present in large quantities in genital fluids.
More persistent or severe symptoms may not surface for years after infection in adults, or for two years in children born with HIV infection. This period of “asymptomatic” infection is highly individual. Some people may begin to have symptoms within a few months, while others may be symptom-free for more than 10 years.
Even during the asymptomatic period, the virus is multiplying, infecting, and killing cells of the immune system, especially T4 cells (CD4+). At the beginning of its life in the human body, the virus disables or destroys these cells without causing symptoms.
The term AIDS applies to the most advanced stages of HIV infection. The Center for Disease Control defines AIDS as all HIV-infected people who have fewer than 200 T4 cells per cubic millimeter of blood. Healthy adults usually have 1,000 or more. In addition, the definition includes over 20 clinical conditions that affect people with advanced HIV disease. Most of these conditions are opportunistic infections that generally do not affect healthy people. Amongst people with AIDS, these infections are often severe and sometimes fatal because the immune system is so damaged by the virus that it can no longer fully resist.
Children with AIDS may get the same opportunistic infections as adults. In addition, they also have severe forms of the bacterial infections that all children may get, such as conjunctivitis (pink eye), ear infections or tonsillitis.
During the course of HIV infection, most people experience a gradual decline in the number of T4 cells, although some may have abrupt and dramatic drops in their T4 cell counts. A person with a T4 cell count above 200 may experience some of the early symptoms of HIV disease, while others may have no symptoms even though their T4 cell count is below 200.
Diagnosis
Because early HIV infection often causes no symptoms, a doctor usually diagnoses it by testing a person’s blood for the presence of antibodies to HIV. HIV antibodies generally do not reach detectable levels in the blood for one to three months following infection.
People exposed to the virus should get an HIV test as soon as they are likely to develop antibodies to the virus i.e. within 6 weeks to 12 months after possible exposure to the virus. By detecting it early, people with HIV infection can discuss with their doctor when they should start treatment to help their immune systems combat HIV and help prevent the emergence of opportunistic infections. Early testing also alerts HIV-infected people to avoid high-risk behaviors that could spread the virus to others.
Health care providers diagnose HIV infection by using two different types of antibody tests, ELISA and Western Blot. If a person is highly likely to be infected with HIV and yet both tests are negative, the doctor may request additional tests. The person also may be told to repeat antibody testing at a later date, when antibodies to HIV are more likely to have developed.
Polymerase chain reaction (PCR) testing is more expensive and labor-intensive but can detect the virus even in someone only recently infected. Urine testing for HIV antibodies is not as sensitive or specific as blood testing but may be used for someone who does not want blood drawn.
Babies born to mothers infected with HIV may or may not be infected with the virus, but all carry their mothers’ antibodies to HIV for several months. If these babies lack symptoms, a doctor cannot make a definitive diagnosis of HIV infection using standard antibody tests until after 15 months of age. By then, babies are unlikely to still carry their mothers’ antibodies and will have produced their own, if they are infected. Health care experts are using new technologies to detect HIV itself to more accurately determine HIV infection in infants between ages 3 months.
To effectively deal with the confusion about AIDS, the diagnosis and it’s treatment requires personal involvement. It really is important that everyone facing AIDS must educate themselves carefully in order to be prepared for the challenges and comfortable with the decisions that will need to be made. While many alternative therapies have turned out to be less effective than initially thought, there is much that can be done to enhance immune function and keep the infection in check.
Conventional Treatment
Three main classes of antiviral drugs are used to treat HIV infection: nucleoside analog reverse transcriptase inhibitors (e.g., zidovudine , didanosine , zalcitibine , stavudine , lamivudine ); non-nucleoside reverse transcriptase inhibitors (e.g., nevirapine , delavirdine ); and protease inhibitors (e.g., saquinavir , ritonavir , indinavir , nelfinavir ). Several other investigational drugs are also used. Treatment with two to four of these drugs is standard. Treatment of the complications of AIDS is specific to the infection or complication present, and frequently includes antibiotics, antifungal medications, corticosteroids, and heart drugs.
Signs, symptoms & indicators of AIDS / Risk
Low lymphocyte count
(Very) frequent stools or normal stool frequency
Weak appetite
Constant fatigue
Fatigue can be one of the most debilitating symptoms experienced by people with HIV disease, as well as one of the most under-reported and under-recognized aspects. The rate of fatigue increases as the disease progresses and women are more likely to experience fatigue than men. HIV-positive men with CD4 cell counts below 500 cells/ml experienced more fatigue than men with CD4 cell counts above 500. However, studies so far have not found a consistent correlation between viral load and fatigue. The fatigue may be due to anemia, depression, the HIV virus, secondary infections, hormone deficiency (testosterone, adrenal exhaustion), malnutrition, poor sleep quality or quantity, inactivity, or drug side-effects.
(Frequent) cervical node swelling
Swollen, firm and possibly tender lymph nodes lasting longer than three months are a symptom of AIDS.
(Frequent) painful cervical nodes
(History of) swollen axillary nodes
(History of) painful axillary nodes
(Often) swollen inguinal nodes
(Often) painful inguinal nodes
Frequent unexplained fevers
Having a high/having a moderate/having a slight fever
Black/brown fingernails
Black nails are sometimes seen in people infected with AIDS.
Conditions that suggest AIDS / Risk
Hypogonadism, Male
Hypogonadism – decreased testosterone production – is a common problem in HIV-infected men.
Low Testosterone Level
An estimated 45% of men with untreated AIDS and 25% of asymptomatic, untreated HIV-infected men experience low testosterone levels. Both men and women may be negatively affected by testosterone deficiency.
Low Adrenal Function / Adrenal Insufficiency
Adrenal insufficiency is considerably less common than hypogonadism in people with HIV, but its incidence increases in advanced cases.
Weakened Immune System
AIDS has a weakening effect on the immune system, resulting in many possible opportunistic infections, some of which would be rarely encountered otherwise. These include pneumocystis pneumonia carinii, candida albicans, toxoplasmosis, cryptosporidiosis, cryptococcal meningitis, tuberculosis, Non-Hodgkins lymphoma, cytomegalovirus and mycobacterium infections. Women also experience increased susceptibility to recurrent vaginitis and cervical cancer (due to decreased resistance to human papiloma virus).Children are susceptible to all the complications demonstrated by adults, plus an increased risk of acute bacterial infection, such as otitis media, meningococcal meningitis, lobar pneumonia, conjunctivitis, ear infections and tonsillitis.
Coccidioidomycosis (Valley Fever)
The depressed cellular immunity seen in HIV infection increases the risk of coccidioidomycosis. Individuals with AIDS are at high risk not only for pulmonary coccidioidomycosis but for the disseminated form and cutaneous form of the disease.
STD Herpes II
AIDS has been associated with frequent and severe genital herpes infections.
Night Sweats
The most common clinical presentations in the high-risk groups or ARC patients includes night sweats. If HIV has progressed to an advanced stage, night sweats become a severe problem.
General fungal/yeast infections
Being confirmed HIV negative
Kaposi's Sarcoma
People with AIDS are particularly prone to developing various cancers, especially those caused by viruses such as Kaposi’s sarcoma, cervical cancer or cancers of the immune system known as lymphomas. Kaposi’s sarcoma is often a late stage complication of AIDS which carries a poor prognosis.
Vaginitis/Vaginal Infection
Scientists are finding that the status of vaginal flora may significantly affect both the amount and the survival of HIV virus inside the female genital tract. Abnormal vaginal flora – i.e. infection with candida or bacterial vaginosis – corresponded with increased amounts of HIV virus in the cervico-vaginal secretions of women who were HIV-positive. The HIV infection rate among women with bacterial vaginosis is twice as high as it is in those with healthy vaginal flora. Understanding these dynamics can “help shape preventative strategies aimed at reducing both heterosexual and the mother-to-child transmission of HIV“, the researchers observed. [BJOG 2001;108: pp.634-641]
Risk factors for AIDS / Risk
Having very/having reduced CD4/CD8
Having normal/having low/having elevated/having slight elevated CD8 count
Patients with high levels of CD8+, CD38+ lymphocyte percent measured as percentage lymphocytes were at a higher risk of developing AIDS, even after adjustment for current CD4 lymphocyte count and serum ß2M levels.
It is generally believed that elevated CD8 counts are advantageous since it’s thought to keep HIV somewhat constrained. Normal CD8 cell counts in an HIV negative person is 275 – 780.
Counter Indicators
Normal T4 helper cell level
Having elevated CD4/CD8
Blood transfusions
African/Latin / Hispanic ethnicity
According to the U.S. Centers for Disease Control and Prevention (CDC), AIDS affects nearly seven times more African Americans than whites. [CDC HIV/AIDS Surveillance Report, Vol. 12, 2000]
Past general fungal/yeast infections
Recent unexplained weight loss
Counter Indicators
No recent unexplained weight loss
Being at risk of HIV/AIDS
Counter Indicators
No HIV/AIDS risk
AIDS / Risk suggests the following may be present
Low Testosterone Level
An estimated 45% of men with untreated AIDS and 25% of asymptomatic, untreated HIV-infected men experience low testosterone levels. Both men and women may be negatively affected by testosterone deficiency.
Low Adrenal Function / Adrenal Insufficiency
Adrenal insufficiency is considerably less common than hypogonadism in people with HIV, but its incidence increases in advanced cases.
Selenium Requirement
Selenium deficiency is an independent factor associated with high mortality among HIV-positive people. HIV-positive people who took selenium supplements experienced fewer infections, better intestinal function, improved appetite, and improved heart function (which had been impaired by the disease) than those who did not take the supplements (400mcg per day). [Biol Trace Elem Res 1989;25: pp.89–96] Blood levels of selenium are frequently low in people with HIV infection.
Kaposi's Sarcoma
People with AIDS are particularly prone to developing various cancers, especially those caused by viruses such as Kaposi’s sarcoma, cervical cancer or cancers of the immune system known as lymphomas. Kaposi’s sarcoma is often a late stage complication of AIDS which carries a poor prognosis.
AIDS / Risk can lead to
Hypogonadism, Male
Hypogonadism – decreased testosterone production – is a common problem in HIV-infected men.
Antioxidant Need/Oxidative Stress w/ Supplements
Free radicals are highly active molecules produced in the body, and are controlled by antioxidants. Researchers found that people with HIV/AIDS (PHAs) have lower-than-normal levels of glutathione (GSH), a chemical that helps the body make antioxidant enzymes. Low levels of GSH has been linked to an increased risk of developing AIDS or dying. Researchers speculate that PHAs produce increased levels of free radicals, which may restrict the body’s ability to produce GSH and other antioxidants. [PMID: 11366794 [PubMed – indexed for MEDLINE]]
Recommendations for AIDS / Risk
Glutamine
A pilot double-blind study of glutamine for intestinal problems in PWAs did not produce statistically significant results, quite possibly because the highest dose used was only 8 grams and most researchers now recommend doses higher than 20 grams for acute problems. However, it did show a trend towards improvement in those on higher doses. Studies of people with other conditions have found that glutamine supplementation speeds recovery and can even restore firm, healthy stools to people who have only inches (of a former 21 feet!) of intestine remaining.
Most people think the intestine is just an organ needed for the elimination of waste, but in fact, it is a crucial part of the immune system. Like people with HIV, cancer patients on chemotherapy often suffer severe diarrhea. Charles Smigelski, RD, a nutritionist and researcher at Harvard University, reports seeing a cancer chemo patient who had disabling diarrhea for six months. Within a week on glutamine, his bowel movements were normal.
Smigelski is high on glutamine and other anti-oxidant supplements for people with HIV. He has about 100 HIV patients in his practice that are supplementing with glutamine and says, Most people report that they feel better on every level. It improves their energy, it reduces diarrhea, and it’s hugely useful in wasting and dealing with oxidative stress. A ton of people swear by it. [http://www.aidsinfonyc.org/]
Thymic Factors
Thymomodulin is one of at least six substances produced by the thymus gland which have been scientifically examined as a possible HIV/AIDS treatment: the others are thymosin a1, THF (thymic humoral factor), TP-5 (thymopentin), thym-uvocal, and thymostimulin. Of the six, thymomodulin, thym-uvocal, and thymostimulin are crude, or “natural,” thymic extracts,
containing a number of chemically distinct substances; the other three are made synthetically, each consisting of a
single molecule.
The largest published study of thymomodulin and HIV was conducted in Italy, and published in 1987. It reported on 15
patients with HIV who were treated with the drug (60 mg per day orally, as a syrup) for more than 50 days. Two of the
patients with late-stage AIDS had no change in their condition, and died shortly after the end of the study. The only one with Kaposi’s sarcoma who entered the study was reported to have had “an evident clinical and laboratory improvement with remission of the neoplasia.”
All of the other 12 showed resolution of fever. All of them started the study with chronic lymphadenopathy, which
disappeared in six of them. Six started with thrush, which disappeared in all but one case. The CD4/CD8 ratio (a measure
no longer considered useful) increased; and the average CD8 count decreased. (This CD8 result is opposite from all of the
anecdotal reports we have heard, a discrepancy which is unexplained.) There was also a statistically significant increase in T-helper cells. No side effects of thymomodulin were seen. And there was no increase in neopterin, an indicator of T-cell activation.
A later study, conducted in Argentina and reported at the International Conference on AIDS in Amsterdam, in July 1992,
treated 11 patients with HIV — ten of whom had AIDS – with a combination of thymomodulin, AZT, and lithium carbonate
“which stimulates granulocytic colony forming units.” Two of the patients had died by the time the results were reported;
the other nine were still on the treatment. “All have a better life-style, weight gaining, less opportunistic infection episodes, and half of them returned to work… Overall, they all improved their CD4 count.”
Garlic
In one study, 10 patients with AIDS who were given 5 to 10gm per day of an aged garlic extract later had increased levels of natural killer cells, a higher helper:suppressor ratio, and reduced infection rates.
MGN3
During the normal progression of this disease, NK cell activity begins to drop along with that of other immune cells. T4 levels routinely decrease at a rate of about 15% per year. Dr Ghoneum, who has been researching MGN-3 since 1993, reports that T4 levels can be maintained in almost every case of AIDS he has tested, and oftentimes they will even begin to increase. Although the number of patients studied has been limited, all of the patients who have taken MGN-3 reported a noticeable difference in their well-being, and have continued to use the product. Most felt that MGN-3 was instrumental in helping them stabilize their disease.
Mistletoe (Viscum album)
A German study examined the use of Iscador, a mistletoe extract, in 40 HIV-positive patients with less than 200 T4 cells/ml. Patients injected themselves subcutaneously with 0.01mg to 10mg of Iscador twice per week for eighteen weeks. The only toxicities were transient fever on the day of injection and soreness at the injection site. The researchers of this small, unblinded and unreviewed study reported that 28 of the 36 patients (77%) had increases in T4 levels of greater than 20%. Iscador should only be administered under the supervision of a doctor familiar with its use. [Gorter R, et al. Abstract PO-B28-2167. IX International Conference on AIDS. Berlin. June 1993]
BHT (Butylated Hydroxytoluene)
BHT is a potent inactivator of lipid-enveloped viruses. The viral envelope structure is physically disturbed by BHT, thereby interfering with viral adsorption to host cells. Since the virus generally believed responsible for AIDS contains a lipid envelope, BHT warrants investigation as a potential antiviral agent against the AIDS virus. Published scientific evidence strongly suggests that BHT might help in treating AIDS or ARC and that any risks can be kept small. No one expects BHT to be a cure, but if it can help in the management of AIDS and/or CMV, it would have value now until better treatments become available.
Sugars Avoidance / Reduction
Sugar and corn syrup found in many desserts impair the engulfing power of white blood cells. The worst offenders are found in canned soda, candy bars, pastry and other processed desserts. Even sugars found in fruit juice, when consumed quickly, will have a depressive effect on immune cells.
Coconut
Lauric acid from coconut oil, coconut milk and fresh or cooked coconut meat, at 24gm daily for adults, may be an effective aid in the destruction of lipid-enveloped viruses such as HIV, HHV-6 (strains A and B), EBV, CMV and herpes. This treatment may be used continuously as viral resistance or immune system adaption is not expected to develop.
Lemons
Reproductive physiologist Roger Short, from the University of Melbourne’s obstetrics department, said a few drops of lemon juice can be a cheap, easy-to-use solution to protect women from both HIV and pregnancy. The juice should be squeezed onto a piece of sponge or cotton wool and placed into the vagina before sex, he said. ”We can show in the lab that lemon juice is very effective in immobilizing human sperm and also very effective in killing HIV… in a 20% concentration.”
The paper refers to additional strategies, including circumcision for men, which more than halves the risk of HIV infection. The virus appears to enter the penis via specific HIV-receptive Langerhans cells on the inner surface of the foreskin. The vagina has its own Langerhans cells that are also the main entry point for HIV in women. Men may also anoint themselves with the acidic juice to prevent transmission.
Lime juice, which has similar acid levels, can also be used. [AllAfrica.com October 4, 2002]
Therapeutic Fasting
Extended fasting should be avoided in AIDS patients, who tend to be malnourished already.
LDN - Low Dose Naltrexone
Since the mid-1980’s, low dose naltrexone (LDN) has consistently demonstrated a markedly beneficial effect in the treatment of HIV/AIDS. There are a score of such patients who, even today, continue to successfully use only LDN. When combined with HAART, LDN has shown itself to be an absolute preventive for lipodystrophy, as well as a synergistic therapy that diminishes viral breakthroughs and bolsters the restoration of CD4 cell levels.
The Promise Of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders. By Elaine Moore, co-author SammyJo Wilkinson Foreword by Dr. Yash Agrawal, MD, PhD.
This is perhaps the first, and so far only book on LDN, and as such represents a milestone in the effort to bring LDN into mainstream use. Written by Elaine Moore, a high level science writer with a portfolio of previous accomplishments, her LDN book is perhaps somewhat technical and may be difficult for the untrained non-professional to follow. It delves into the sophisticated jargon of the medical research world. For example, in Chapter 5 on LDN and Cancer, there is a discussion of Zagon’s work on Cyclin dependent kinases, P53 and protein 21 and how this relates to inhibition of cancer by LDN.
However, in addition to the esoteric technical sections of the book, there are also chapters devoted to the lay reader interested in learning how LDN can help them on a practical level. A listing of dispensing practitioners was included which I found contained my own office address and phone number.
The book is highly recommended for other health care practitioners who wish to get quickly up to speed in this new area of medicine which is destined to become the medical paradigm of the 21st century, casting a giant shadow over the rest of mainstream medicine.[ Comments on the LDN book by Jeffrey Dach MD]
Conventional Drugs / Information
Prednisone must be used cautiously by HIV-positive individuals because it is immunosuppressive and can increase the risk of getting opportunistic infections.
ATRIPLA contains 3 medicines, SUSTIVA (efavirenz), EMTRIVA (emtricitabine) and VIREAD (tenofovir disoproxil fumarate also called tenofovir DF) combined in one pill. EMTRIVA and VIREAD are HIV (human immunodeficiency virus) nucleoside analog reverse transcriptase inhibitors (NRTIs) and SUSTIVA is an HIV non-nucleoside analog reverse transcriptase inhibitor (NNRTI). VIREAD and EMTRIVA are the components of TRUVADA. ATRIPLA can be used alone as a complete regimen, or in combination with other anti-HIV medicines to treat people with HIV infection. ATRIPLA is for adults age 18 and over.
Plant Sterols / Sterolins (Phytosterols)
The use of the mixture by HIV-infected individuals has been extensively studied. It has been shown to prevent the decline of CD4 cell numbers (a surrogate marker of disease progression), decrease the plasma viral loads of patients and maintain a relatively intact immune profile despite the chronic viral infection. This implies that the use of the immune modulator (such as Moducare) by HIV-infected individuals would prevent the deterioration of the immunity and the maintenance of effective cellular responses to the virus. [S.Afr. Med. J. (2001) 91, pp.848-850, Cell Biol. Int. (2001) 25, pp.43-49]
Beta 1,3 Glucan
The first human study on Beta-1,3-glucan’s systemic effect was done in the mid 1980s’s on advanced HIV infection. An increase in serum cytokines IL-1, IL-2 and Interferon was measured.
Aerobic Exercise
Exercise of any type 3 – 4 times per week or more has been associated with slower progression to AIDS at one year and with a slower progression to death from AIDS at one year in men. [Ann Epidemiol 1999;9: pp.127–31]
Test for HIV / AIDS
HIV, the virus that causes AIDS, can be diagnosed from a mouth swab as accurately as from a blood sample, Canadian scientists said. This is a pain-free, non-invasive saliva test. Researchers from McGill University in Montreal said that their saliva HIV test OraQuick HIV 1/2 was 99% accurate for HIV in high-risk populations and about 97% in low-risk populations. [The Lancet Infectious Diseases, January 24, 2012]
Test / Monitor Hormone levels
Several studies have shown that testosterone levels are generally lower and that testosterone administration alleviates fatigue and depression in men with HIV/AIDS. In one study, 80% of men reported significant improvements in their energy levels. [General Hospital Psychiatry, July 1998]
Zinc
Blood levels of selenium are frequently low in people with HIV infection. Zinc supplements (45mg per day) have been shown to reduce the number of infections in people with AIDS. [Int J Immunopharmacol 1995;17: pp.719-27]
Physical Therapy
Male circumcision (MC) markedly decreases the acquisition of HIV infection, the major epidemic of our time. This is the first biological intervention shown to prevent HIV infection and will not depend upon continuing behaviour change to give protection. In 1986, five years after the description of AIDS, the first article suggesting that male circumcision is associated with lower risk of human immunodeficiency virus (HIV) infection was published. During the following 15 years, different studies – almost exclusively from sub-Saharan Africa, which quickly became the centre of HIV epidemic – increasingly supported this hypothesis. For example, tribes and other defined populations with low prevalence of MC had high prevalence of HIV infection, suggesting a correlation between MC and HIV prevention.
Despite that, there was still uncertainty among many scientists and public health scientific societies, mainly due to the fear that circumcised men have different (safer) sexual practices than men who are not, and that this and not male circumcision led to lower rates of HIV infection in circumcised men and in populations where circumcision is common. To eliminate this concern, three specifically designed trials were carried out.
In 2005, the results of the first trial showed a 60% protective effect against HIV infection among the men who were circumcised (Bertran Auvert and colleagues, PLoS Med. 2005;2:e209). The study has been conducted on the behalf of the South African National Institute for Communicable Diseases (Johannesburg) and the Institut National de la Santé et de la Recherche Médicale (ANRS Paris, France), involving 3,274 men who were randomized to receive circumcision or not. The subjects were followed over a mean period of 18.1 months, and the trial was stopped prematurely because of the high efficacy observed among circumcised patients.
In February 2007, the second and third studies found a protective effect of 53% and 51% respectively in men who were circumcised, compared to those who were not (Robert Bailey and colleagues, Lancet 2007; 369:643-56 – Ronald Gray and colleagues, Lancet. 2007; 369:657-66). The second trial enrolled 2,784 men and was carried out on the behalf of the U.S. National Institutes of Health and the Canadian Institute for Health Research, while the third study, also sponsored by the National Institutes of Health, randomised 4,996 men. Each of these trials was also stopped prematurely on 12 December 2006, due to an extremely high efficacy rate. The findings of the studies are similar, and remarkably consistent with the protective effect (58% on average) found in a systematic review of observational studies available in medical literature.
“Current data show that circumcision of adult men results in an approximately 60% reduction in acquisition of HIV infection”, said Dr. George Schmid (Dept. of HIV / AIDS, World Health Organization, Geneva, Switzerland).
About 30% of men are estimated to be circumcised worldwide, although this rate is still less than 20% in Europe.
Multiple Vitamin Supplement
HIV-positive men who took a multivitamin-mineral supplement had slower onset of AIDS, compared with men who did not take a supplement. [Med Tribune 1993;9:18]
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Strongly counter-indicative |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
| Reasonably likely to cause problems |
Glossary
Epidemic
Describes a disease occurring in extensive outbreaks, or with an unusually high incidence at certain times and places.
Virus
Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
HIV
Abbreviation for human immunodeficiency virus, a retrovirus associated with onset of advanced immunodeficiency syndrome (AIDS).
Immune System
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.
Lymph Nodes
Small, bean-shaped nodes at various points throughout the body that function to filter the lymph fluid and attempt to destroy the microorganisms and abnormal cells which collect there. The most common locations are the neck (both sides and front), armpit and groin, but also under the jaw and behind the ears. Swollen or painful lymph nodes generally result from localized or systemic infection, abscess formation, or malignancy. Other causes of enlarged lymph nodes are extremely rare. Physical examination for lymph nodes includes pressing on them to check for size, texture, warmth, tenderness and mobility. Most lymph nodes can not be felt until they become swollen, and then will only be tender when pressed or massaged. A lymph node that is painful even without touching indicates greater swelling. Lymph nodes can usually be distinguished from other growths because they generally feel small, smooth, round or oval-shaped and somewhat mobile when attempts are made to push them sideways. Because less fat covers the lymph nodes in children, they are easier to feel, even when they are not busy filtering germs or making antibodies. Children’s nodes enlarge faster, get bigger in response to an infection and stay swollen longer than an adult's.
Asymptomatic
Not showing symptoms.
T4
Thyroxin, thyroid hormone also prepared synthetically, for treatment of hypothyroidism and myxedema.
CD4
A symbol for glycoprotein expressed on the surface of some lymphocytes, including Helper T cells. Human CD4 is the receptor that serves as a docking site for HIV viruses on certain lymphocyte cells. Binding of the viral glycoprotein gp120 to CD4 is the first step in viral entry, leading to the fusion of viral and cell membrane. In a healthy adult, helper T-cells account for between 32% and 68% of the total number of lymphocytes (which includes B-cells and other types of T-cells). The CD4 percentage is sometimes a more reliable measurement than the CD4 count because it tends to vary less between measurements. For example, one person's CD4 count may vary between 160 and 240 over a period of several months while their CD4 percentage remains constant at, say, 15%. The reason for this is that the CD4 count isn't actually a direct count of CD4 cells, but rather a calculation based on the results of three other tests (the CD4 percentage, the lymphocyte percentage, and the WBC count), each of which can vary slightly each time it's measured. Occasionally the CD4 count may be relatively high while the CD4 percentage is low (less than 21%). In this situation, many healthcare providers would consider the immune system to be significantly impaired based on the CD4 percentage.
Millimeter
(mm): A metric unit of length equaling one thousandth of a meter, or one tenth of a centimeter. There are 25.4 millimeters in one inch.
Antibody
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
ELISA
(Enzyme-Linked Immunosorbent Assay): A test that detects the presence of the AIDS virus or Lyme Disease antibodies.
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Adrenal Insufficiency
Also known as Adrenal Exhaustion or Low Adrenal Function, this is a condition where the adrenal gland is compromised in its production of epinephrine, norepinephrine, cortisol, corticosterone or aldosterone. Symptoms include primarily fatigue, weakness, decreased appetite with ensuing weight loss, as well as nausea, vomiting, abdominal pain, diarrhea or constipation, or increased pigmentation of the skin. Cortical insufficiency (low or no corticosteroids) produces a more serious condition called Addison’s Disease, characterized by extreme weakness, low blood pressure, pigmentation of the skin, shock or even death.
Candidiasis
Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge.
Tuberculosis
Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
Lymphoma
Any tumor of the lymphatic tissues.
Cytomegalovirus
(CMV): A member of the herpes virus family which may induce the immune-deficient state or cause active illness, such as pneumonia, in a patient already immune-deficient due to chronic illness, such as cancer or organ transplantation therapy.
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Otitis Media
A very common condition involving inflammation of the middle ear and can be classified as either acute otitis media (AOM), or otitis media with effusion (OME) which is a chronic disease. It most commonly affects infants and young children but can affect all age groups. Symptoms of AOM include earache, decreased hearing, fever, unsteadiness, and occasionally liquid discharge if the eardrum bursts. Symptoms of OME include decreased hearing, tinnitus and unsteadiness, but OME can be entirely without symptoms. Effusions (discharges) continue for several weeks after AOM; only 60% of ears with AOM are clear at 2 weeks and 80% are clear by 8 weeks.
Cellular immunity
A branch of the immune system which involves direct attack by immune cells often called "T" cells. Antibodies play less of a role.
Pulmonary
Pertaining to the lungs.
Shingles
A severe infection caused by the Varicella-Zoster virus (VZV), affecting mainly adults. It causes painful skin blisters that follow the underlying route of brain or spinal nerves infected by the virus. Also know as herpes zoster.
CD8
CD8 cells, also called suppressor and cytotoxic T-cells, play a role in fighting viral infections such as HIV. A T lymphocyte that secretes large amounts of gamma-interferon, a lymphokine involved in the body's defense against viruses. CD8 cells prevent the unnecessary formation of antibodies. A healthy adult usually has between 150 and 1,000 CD8 cells per cubic millimeter. In contrast to CD4 cells, people with HIV often have elevated numbers of CD8 cells, the significance of which is not well understood. Lab reports may also list the T-cell ratio, which is the number of CD4 cells divided by the number of CD8 cells. Since the CD4 count is usually lower and the CD8 count higher than normal, the ratio is usually low in people with HIV. A normal T-cell ratio is usually between 1.5 and 2.5 to 1. The expected response to effective combination anti-HIV treatment is an increase in CD4 count, a decrease in CD8 count, and an increase in the T-cell ratio.
Lymphocyte
A type of white blood cell found in lymph, blood, and other specialized tissue such as bone marrow and tonsils, constituting between 22 and 28 percent of all white blood cells in the blood of a normal adult human being. B- and T-lymphocytes are crucial components of the immune system. The B-lymphocytes are primarily responsible for antibody production. The T-lymphocytes are involved in the direct attack against living organisms. The helper T-lymphocyte, a subtype, is the main cell infected and destroyed by the AIDS virus.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Selenium
An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.
Microgram
(mcg): 1/1,000 of a milligram in weight.
Free Radical
A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.
Antioxidant
A chemical compound that slows or prevents oxygen from reacting with other compounds. Some antioxidants have been shown to have cancer-protecting potential because they neutralize free radicals. Examples include vitamins C and E, alpha lipoic acid, beta carotene, the minerals selenium, zinc, and germanium, superoxide dismutase (SOD), coenzyme Q10, catalase, and some amino acids, like cystiene. Other nutrient sources include grape seed extract, curcumin, gingko, green tea, olive leaf, policosanol and pycnogenol.
Glutathione
A natural sulfur-bearing peptide formed from the linking of three amino acids: glutamic acid, cysteine and glycine. Glutathione acts as an antioxidant and detoxicant and is involved with the selenium-containing enzyme glutathione peroxidase. Glutathione is also involved in amino acid transport across cell membranes.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.