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Acquired immunodeficiency syndrome (AIDS) is a chronic and potentially fatal disease of the immune system caused by the human immunodeficiency virus (HIV), which attacks a specific type of white blood cells known as T-lymphocytes. These cells are measured in the blood as the CD4 count. The lower the CD4 count, the weaker the immune system. As the immune system grows weaker, people with HIV and AIDS are susceptible to infections and cancers that the immune system would ordinarily fight off. More than 50,000 new cases of HIV infections occur in the United States every year. A massive research effort has produced better treatments, resulting in longer survival and improved quality of life for those with access to the treatments. But there is still no vaccine or cure.
Signs and Symptoms
Symptoms of infection with HIV can vary. A flu like syndrome occurs in 40 - 90% of those who contract HIV within the first 2 - 6 weeks, including a combination of the following symptoms:
After infection with HIV, you may remain relatively symptom free for years, or the disease may progress more rapidly. In this stage, the CD4 count is below 500/microliter. You may develop infections or chronic symptoms, including:
During the last stage of the disease, HIV infection may meet the official criteria for AIDS, which is the presence of an opportunistic infection (such as Pneumocystis carinii pneumonia, or PCP) or a CD4 count below 200/microliter. At this stage, symptoms may include:
What Causes It?
HIV infection causes AIDS. HIV is spread primarily through sexual contact, and also through blood to blood contact, needle sharing among intravenous drug users, and, in pregnant women, from mother to child. Worldwide, about 80% of HIV transmission occurs through sexual contact. Blood transfusions and blood products caused many infections in the early years of the epidemic, but screening procedures have nearly eliminated this risk in the United States and other developed countries. A mother can spread the virus to a newborn during delivery and through breastfeeding, although drug therapy available in the developed world can greatly reduce the risk to infants.
Risk factors include:
What to Expect at Your Provider's Office
If your health care provider suspects HIV infection, you may receive a "rapid test," which can provide results in 20 minutes. If the test is positive, your health care provider will order a blood test to detect antibodies against the virus. If this test is positive, the doctor will order a CD4 count (see above) and a viral load (an indication of the amount of virus present). This information, along with your symptoms, helps the doctor see what stage the disease is in and determine the best course of treatment for you, including the appropriate tests and medications. For example, if you are experiencing shortness of breath, your doctor will order a chest x-ray, particularly if your CD4 count is low. Some symptoms and tests may require evaluation in the hospital.
HIV tests may not be accurate immediately after you are infected, because it can take up to 12 weeks for your body to develop antibodies against the virus. If you suspect you have been infected and your test is negative, you may need to be retested after a short time to confirm the result.
If you do test positive for HIV, you will be asked to tell your sexual partners immediately so they can also be tested.
Many valuable medications can slow the progression of HIV infection to full blown AIDS. Treatment is usually initiated when the CD4 count falls to a certain level. Generally, physicians use a combination of these medicines, including a type called protease inhibitors. In addition, antibiotics and other therapies are used to prevent or treat specific complications. It is important that a doctor who specializes in HIV direct your care. Your health care provider will know the most effective treatment for you, including the most current medical regimen, what alternative treatments are safe, and which combinations may be harmful. If you are using any alternative therapies to complement your medical regimen, be sure to share this information with your doctor.
A combination of drugs is used to treat HIV very aggressively, with the aim of reducing the amount of virus in your blood to very low or undetectable levels and to suppress symptoms for as long as possible.
Antiretroviral drugs help slow the progression of HIV by inhibiting the reproduction of the virus in your blood. It's important to keep a steady dose of antiretroviral drugs in your body to prevent the virus from developing resistance to the drugs. Antiretroviral medications include:
In addition, any opportunistic infections are treated with the appropriate medications, or in some cases medications are given to prevent the infections from occurring (prophylaxis).
Complementary and Alternative Therapies
Many people with HIV turn to complementary and alternative therapies to reduce symptoms of the virus, lessen side effects from medications, improve overall health and well being, and gain a sense of empowerment by being actively involved in their own care.
Different therapies are used to:
Since the major impact of HIV is that it leaves patients vulnerable to opportunistic infections, making adjustments to ensure your overall health through improving stress reduction, exercise, building a social support network, and having a spiritual practice can significantly boost immune function. In fact, these actions are some of the most powerful tools a person has to impact the course of the disease. Other changes, such as improving oral and general hygiene and limiting exposure to environmental pollutants, can also bolster your health and vitality. These small steps can add up to a longer and healthier life for many people.
However, HIV should never be treated with alternative therapies alone. It is extremely important that you share information on your use of complementary and alternative therapies with your doctor, so that your doctor can help you determine what is safe and appropriate. Some herbs and/or nutrients can interfere with HIV/AIDS medications and new information on herb/drug interactions, both beneficial and detrimental, are being uncovered all the time, so it is vital that you work with a knowledgeable provider to determine the proper nutrition and supplement program for your health.
Nutrition and Supplements
These nutritional tips may help reduce symptoms:
You may address nutritional deficiencies with the following supplements:
Weight loss can be a serious problem for people with HIV. This symptom may begin early in the course of the disease and can increase the risk for developing opportunistic infections. Weight loss is exacerbated by other common symptoms of HIV and AIDS, including lesions in the mouth and esophagus, diarrhea, and poor appetite. Over the last several years, weight loss has become less of a problem due to the new protease inhibitors used for treating HIV. Reduction of muscle mass, though, remains a significant concern. Working with a registered dietitian to develop a meal plan to prevent weight loss and muscle breakdown is extremely helpful. Resistance training (lifting weights) can also protect against muscle breakdown and increase lean body mass.
Preventing diarrhea and ensuring that the body absorbs enough protein to maintain muscle strength has become a major goal of HIV/AIDS preventative care. One program for combating diarrhea includes using soluble fiber (not insoluble fiber, such as Metamucil and psyllium husks). For some people, soluble fiber can help food stay in the digestive tract for longer periods of time, increasing the amount of nutrients that are absorbed, and lessening bowel frequency. Good sources of soluble fiber include apple pectin, oat bran, and flax seed. Because diarrhea can be a potentially life threatening situation, use soluble fiber therapy only under the strict supervision of a trained professional.
Herbs are a way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day.
You may use herbs as supportive therapies, but never use them alone to treat HIV or AIDS. Tell all of your health care providers about any treatments, conventional or alternative, you are taking so they can monitor interactions and side effects, and provide the best care. Always work with a complementary and alternative (CAM) practitioner who is knowledgeable in HIV care. HIV medicine is changing continually and practitioners need to stay up-to-date on the latest medication and herb/drug/nutrient interactions.
You should stop taking St. John's wort (Hypericum perforatum), which has a negative effect on indinavir and could lead to developing resistance to the drug. You should also aovid echinacea (Echinacea spp.) and astragalus (Astragalus membranaceus). These two substances show conflicting evidence of enhancing immune function and strengthening replication of the HIV virus in test tubes.
No specific scientific research supports the use of homeopathy for HIV or AIDS. A licensed, certified homeopathic doctor would evaluate you individually to assess the value of homeopathy for reduction of symptoms or side effects from medication as an adjunct to standard medical treatment.
Exercise is another way to help develop a general sense of well being, improve mental attitude, decrease depression, diminish weight loss, and increase lean body mass. Resistance or weight training is particularly useful to increase strength and enhance lean body mass.
People with HIV have used acupuncture to improve general well being, alleviate symptoms such as fatigue, insomnia, and night sweats, and to minimize side effects from medications, such as nausea and diarrhea. Some people also find relief from peripheral neuropathy, caused occasionally by certain medications used for HIV, reporting less pain, increased strength, and improved sensation.
In China, acupuncture and moxibustion (a heat treatment performed by the acupuncturist over points where the needles are placed) are the standard treatments for HIV-related diarrhea.
Acupuncture can also be used to treat the neuropathic (nerve) pain associated with certain HIV medications. Inserting needles bilaterally in the hand and foot points known as Baaxie and Bafeng, respectively, can lessen neuropathic pain.
Massage can relieve chronic muscle tension and stress, which may help the immune system.
If you are HIV positive and pregnant, taking certain antiretroviral medications will reduce the likelihood of you transmitting the virus to your baby. Your doctor will determine which medicine is best for you and safe for your baby. Depending on your own condition, you and your health care provider may decide to postpone treatment until after your first trimester to reduce the risk of birth defects. The drug efavirenz (Sustiva) should be avoided throughout pregnancy. If you are HIV-positive, you should not breastfeed because of the risk of transmission to your baby.
Bepe N, Madanhi N, Mudzviti T, Gavi S, Maponga CC, Morse GD. The impact of herbal remedies on adverse effects and quality of life in HIV-infected individuals on antiretroviral therapy. J Infect Dev Ctries. 2011;5(1):48-53.
Chang BH, Sommers E. Acupuncture and the relaxation response for treating gastrointestinal symptoms in HIV patients on highly active antiretroviral therapy. Acupunct Med. 2011;29(3):180-7.
Chu Y, Liu H. Advances of research on anti-HIV agents from traditional Chinese herbs. Adv Dent Res. 2011;23(1):67-75.
Faintuch J, Soeters PB, Osmo HG. Nutritional and metabolic abnormalities in pre-AIDS HIV infection. Nutrition. 2006;22(6):683-90.
Ferri: Ferri's Clinical Advisor 2010, 1st ed. Philadelphia, PA: Mosby Elsevier. 2009.
Han H, He W, Wang W, Gao B. Inhibitory effect of aqueous dandelion extract on HIV-1 replication and reverse transcriptase activity. BMC Complement Altern Med. 2011;11:112.
Harris A, Bolus NE. HIV/AIDS: An update. Radiol Technol. 2008;79(3):243-52.
Hasan SS, See CK, Choong CL, Ahmed SI, Ahmadi K, Anwar M. Reasons, perceived efficacy, and factors associated with complementary and alternative medicine use among Malaysian patients with HIV/AIDS. J Altern Complement Med. 2010;16(11):1171-6.
Hendricks MK, Eley B, Bourne LT. Colecraft E. HIV/AIDS: nutritional implications and impact on human development. Proc Nutr Soc. 2008;67(1):109-13.
Highleyman L. Nutrition and HIV. BETA. 2006;18(2):18-32.
Hillier SL, Louw Q, Morris L, Uwimana J, Statham S. Massage therapy for people with HIV/AIDS. [Review]. Cochrane Database Syst Rev. 2010;(1):CD007502.
Hoogbruin A. Complementary and alternative therapy (CAT) use and highly active antiretroviral therapy (HAART): current evidence in the literature, 2000-2009. J Clin Nurs. 2011;20(7-8):925-39.
Hoppe C, Andersen GS, Jacobsen S, et al. The use of whey or skimmed milk powder in fortified blended foods for vulnerable groups. J Nutr. 2008;138(1):145S-161S.
Irlam JH, Visser MM, Rollins NN, Siegfried N. Micronutrient supplementation in children and adults with HIV infection. [Review]. Cochrane Database Syst Rev. 2010;(12):CD003650. Review.
Joy T, Keogh HM, Hadigan C, et al. Dietary fat intake and relationship to serum lipid levels in HIV-infected patients with metabolic abnormalities in the HAART era. AIDS. 2007;21(12):1591-600.
Liu JP, Manheimer E, Yang M. Herbal medicines for treating HIV infection and AIDS. Cochrane Database Syst Rev. 2005;(3):CD003937.
Liu X, Han Y, Peng K, Liu Y, Li J, Liu H. Effect of traditional Chinese medicinal herbs on Candida spp. from patients with HIV/AIDS. [Review]. Adv Dent Res. 2011;23(1):56-60.
Louie L, Pathanapornpandh N, Pultajuk U, Kaplan R, Hodgson I, Maund L, Greenlee H. The Mae On Project: using acupuncture for symptom relief and improved quality of life for people living with HIV and AIDS in rural Thailand. Acupunct Med. 2010;28(1):37-41.
Nance CL, Siwak EB, Shearer WT. Preclinical development of the green tea catechin, epigallocatechin gallate, as an HIV-1 therapy. J Allergy Clin Immunol. 2009;123(2):459-65.
Oliveira JM, Rondó PH. Omega-3 fatty acids and hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: systematic review and meta-analysis. [Review]. HIV Clin Trials. 2011;12(5):268-74.
Rakel & Bope: Conn's Current Therapy 2009, 1st ed. Philadelphia, PA: Saunders Elsevier. 2008.
Romanelli F, Matheny S. HIV Infection: The Role of Primary Care. Am Fam Phys. 2009;80(9).
Stone CA, Kawai K, Kupka R, Fawzi WW. Role of selenium in HIV infection. [Review]. Nutr Rev. 2010;68(11):671-81.
Suttajit M. Advances in nutrition support for quality of life in HIV+/AIDS. Asia Pac J Clin Nutr. 2007;16 Suppl 1:318-22.
Tabi M, Vogel RL. Nutritional counseling: an intervention for HIV-positive patients. J Adv Nurs. 2006;54(6):676-82.
Wang J, Zou W. Practices, challenges, and opportunities: HIV/AIDS treatment with traditional Chinese medicine in China. [Review]. Front Med. 2011;5(2):123-6.
Yeh SS, Lovitt S, Schuster MW. Pharmacological treatment of geriatric cachexia: evidence and safety in perspective. J Am Med Dir Assoc. 2007;8(6):363-77.
Wiysonge CS, Shey M, Kongnyuy EJ, Sterne JA, Brocklehurst P. Vitamin A supplementation for reducing the risk of mother-to-child transmission of HIV infection. [Review]. Cochrane Database Syst Rev. 2011;(1):CD003648.
Zetola NM, Bernstein KT, Wong E, Louie B, Klausner JD. Exploring the relationship between sexually transmitted diseases and HIV acquisition by using different study designs. J Acquir Immune Defic Syndr. 2009;50(5):546-51.
Review Date: 4/4/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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