Die effek van mikronutriëntsupplementasie op merkers van verworwe immuniteitsgebreksindroom

Abstract

Nutritional factors are not the most important etiological determinant of human immunodeficiency virus (HIV) infection, but it may modulate immune functions to affect viral expression and have a significant impact on the disease progression and related morbidity and mortality. Micronutrient deficiencies affect immune functions and are common in HIV patients. The aim of the study was therefore to investigate the effect of micronutrient supplementation on specific immune markers of HIV progression and serum vitamin levels and to determine whether supplementation with micronutrients and phytochemicals can delay the disease progression of HIV/AIDS (acquired immunodeficiency syndrome). A double-blind, placebo controlled intervention trial was performed with 30 African HIV-infected patients in the North West and Gauteng provinces. Experimental subjects were randomly divided into two groups, receiving dietary supplements (Phytogard® and Ultragard Fort ®) or placebos for six months. Both groups received a low-dose multivitamin tablet because of ethical considerations. Serum vitamin concentrations, CD4 and COB lymphocyte counts, viral load and selected acute-phase proteins were determined at baseline and after six months. The most important findings of the study were a statistically significant (p<0.04) increase in viral load in the control group after six months. The CD8 lymphocyte counts of both groups decreased significantly (p=0.019 for the experimental group and p=0.0047 for the control group). There were no significant changes in the acute phase proteins within the groups. However, the C-reactive protein levels of the control group were significantly higher than those of the experimental group after six months (p=0.015), which correspond with the increased viral load in this group. The red blood cell sedimentation rate was higher than the normal range in both groups and doubled during the study (p<0.02). The serum vitamin C levels of the experimental group increased significantly after six months (p=0.02). The vitamin E levels of the control group were significantly lower (p=0.0007 4) than that of the experimental group after the intervention. Although the vitamin status improved with micronutrient and phytochemical supplementation, no clinical beneficial effect on immune markers was observed. Therefore, no valid conclusions could be drawn whether micronutrient supplementation delayed the disease progression of HIV clinically significantly, and further studies in similar groups of patients are necessary to answer the question.