ABSTRACT
OBJECTIVE: To evaluate the efficacy of combination protease and reverse transcriptase inhibitor therapy in correcting HIV-1-induced lymphocyte subset abnormalities in previously treated adults. DESIGN: A 48-week observational study of lymphocyte subsets in 12 participants in the Multicenter AIDS Cohort Study who were already taking at least one reverse transcriptase inhibitor and added a protease inhibitor to their treatment regimen. Comparison groups were HIV-seronegative homosexual men, HIV-seronegative heterosexual men, and homosexual HIV-1-infected men who were long-term non-progressors. METHODS: Three-color immunofluorescence and monoclonal antibodies were used to assess HIV-1-induced lymphocyte subset alterations related to immune deficiency and immune activation. Plasma HIV-1 RNA levels were monitored to assess suppression of viral replication. RESULTS: CD4+ cell counts significantly increased and lymphocyte activation measured as CD38 and HLA-DR expression on CD8+ T cells significantly decreased by 48 weeks. CD4+ cell values remained abnormal even in those who were fully suppressed. Some T-cell activation markers decreased to levels observed in long-term non-progressors. The increase in CD4+ T-cell numbers reached a plateau by week 24, but the increase in resting HLA-DR- CD38-T cells was sustained through week 48. Proportions of CD45RA+ CD62L-selectin+ and CD28+ CD4+ T-cell subsets and Fas expression were not abnormal at baseline compared with seronegative homosexual controls. CONCLUSIONS: The most significant impact of suppression of viral replication was reversal of T-cell activation. However, normalization of lymphocyte subset perturbations associated with chronic HIV-1 infection was not achieved after 1 year of treatment with current combination antiretroviral regimens. More profound viral suppression, therapy for longer than 1 year, or immunologic augmentation may be needed to fully reverse the abnormalities.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Infections/immunology , HIV Protease Inhibitors/therapeutic use , HIV-1 , Reverse Transcriptase Inhibitors/therapeutic use , Adult , Antibodies, Monoclonal , CD4 Lymphocyte Count , Chronic Disease , Cohort Studies , Drug Therapy, Combination , Fluorescent Antibody Technique , HIV Infections/drug therapy , HIV Long-Term Survivors , HIV Seronegativity , Homosexuality, Male , Humans , Lymphocyte Activation , Male , RNA, Viral/blood , T-Lymphocyte Subsets/immunology , Virus ReplicationABSTRACT
AIDS: Essiac, an herbal formulation from the Ojibway Indians in Canada, is composed of four herbs: burdock root, sheep sorrel, turkey rhubarb root, and slippery elm bark. After her discovery of Essiac in 1922, Rene Caisse reported treating and "curing" hundreds of people with cancer and other chronic diseases. The rights to the "original" Essiac now belong to Elaine Alexander of Vancouver, who is currently working with an unnamed health products company to research, test, manufacture, and distribute Essiac. However, there are a variety of sources for Essiac in the United States. According to former chiropractor Gary Glum, sheep's sorrel destroys cancer cells; the other three herbs are blood purifiers. In addition, Dr. Jim Chan, naturopathic physician, says burdock root contains inulin, a powerful immune modulator. However, there has been no basic research done with these herbs to demonstrate their true mechanisms of action. In addition, only anecdotal reports provide information about results. Only laboratory and clinical studies will confirm the anti-tumor and immune-modulating effects of Essiac.^ieng
