Effect of N-acetyl-L-cysteine on lymphocyte apoptosis, lymphocyte viability, TNF-alpha and IL-8 in HIV-infected patients undergoing anti-retroviral treatment

N-acetyl-L-cysteine (NAC) has been proposed as an additional therapeutic agent for AIDS patients because it reduces human immunodeficiency virus type 1 (HIV-1) replication in stimulated CD4+ lymphocytes, and it ameliorates immunological reactivity. In a randomized, 180-day, double-blind, placebo-controlled trial performed with HIV-infected patients classified as A2 and A3 according to the criteria of the Center for Disease Control and Prevention, we investigated the effects of oral administration of NAC on HIV-infected patients undergoing their first anti-retroviral therapy; viral load, CD4+ lymphocyte, lymphocyte viability and apoptosis, and TNF-alpha and IL-8 levels were determined. Sixteen patients who received anti-retroviral therapy plus a placebo formed the control group and the study group consisted of 14 patients who received anti-retroviral therapy and NAC supplementation. A significant decrease was seen in viral load, TNF-alpha and IL-8 levels, and lymphocyte apoptosis, and a significant increase was found in levels of CD4+ lymphocytes and lymphocyte viability in both groups after anti-retroviral treatment, but no measurable benefits of anti-retroviral therapy plus NAC oral supplementation (600 mg/day) were found in relation to anti-retroviral therapy alone, and the baseline levels of cysteine and glutathione in plasma were not recovered by this treatment. In conclusion, the daily doses of NAC necessary for the total recuperation of plasma cysteine and glutathione levels in HIV-infected patients and the additional benefits following the supplementation of NAC in patients submitted to anti-retroviral therapy, need to be studied further.

Suplementaçäo de N-acetilcisteína em pacientes infectados pelo HIV submetidos ao primeiro tratamento anti-retroviral: avaliaçäo do efeito sobre a carga viral, TNF-"alfa", IL-6, IL-8, "beta"2-microglobulina, IgA, IgG e IgM, haptoglobina e "alfa"1-glicoproteína ácida / N-acetylcysteine supplementation of HIV-infected patients under the first anti-retroviral treatment: evaluation of the effect on viral load, TNF-

Indivíduos infectados pelo vírus da imunodeficiência humana (HIV-I) apresentam aumento progressivo da carga viral, da destruiçäo do sistema de defesa imune celular e alterações imunológicas e inflamatórias, incluindo a elevaçäo dos níveis séricos do fator de necrose tumoral alfa (TNF-"alfa"), interleucina 8 (IL-8), "beta"2-microglobulina, IgA, IgG e IgM, haptoglobina e "alfa"1-glicoproteína ácida. O objetivo deste estudo foi avaliar os níveis séricos destes marcadores em indivíduos submetidos ao primeiro tratamento antiretroviral, suplementados ou näo com N-acetilcisteína. Participaram deste estudo, duplo cego controlado por placebo, que teve a duraçäo de 180 dias, 24 indivíduos que iniciaram a terapia...