Conditions

Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus (HIV) is a type of virus known as a retrovirus. Retroviruses actually take over the genetic material of the cells they invade, causing the cells to create additional copies of the virus.

In the case of HIV, the particular cells the virus invades are called T-lymphocytes (T-cells), a type of white blood cell that is a key component of the immune system. As HIV uses T-cells to manufacture copies of itself, the copies invade other T-cells. This process is repeated over and over, destroying more and more T-cells and seriously weakening the body's ability to fight off infection and disease.

A healthy person has a T-cell count of between 1,000 and 1,500 per a microliter of blood. People with acquired immunodeficiency syndrome (AIDS ­ the severest stage of HIV disease) generally have a T-cell count of 200 or less.

As the person's T-cell count continues to fall, he or she becomes susceptible to a wide array of infections and other illnesses, many of which are otherwise quite rare. These include (but are hardly limited to):

• Pneumocystis carinii pneumoina (PCP) ­ fungal pneumonia
• Persistent and systemic candida infection ­ oral thrush and persistent vaginitis (two of the most common forms)
• Kaposi's sarcoma ­ form of skin cancer
• Toxoplasmic encephalitis ­ infection of the brain caused by parasite
• Cytomegalovirus (CMV) infection ­ common virus in most people's blood. Effects an AIDS victim's kidneys, central nervous system and eyes.

Virtually all infectious diseases are more common and more dangerous in people who have HIV.

If a person's T-cell count falls below 200 or certain characteristic infections or cancer develop, he or she is diagnosed with AIDS. The time between infection with HIV and the development of AIDS varies greatly. Generally, an otherwise healthy person who contracts HIV can expect eight to twelve years of continuing health before the onset of AIDS.

HIV is contracted principally through sexual or blood-to-blood contact, such as occurs during blood transfusions or needle sharing. Women who are HIV-positive can transmit the virus to a developing fetus during pregnancy or to an infant during childbirth or through breastfeeding.

HIV cannot be transmitted from one person to another though coughing and sneezing, as colds can, nor through normal every day interactions at home or work, including hugs and dry kisses. You should also understand that it is not possible to contract the virus by donating blood. It is also important to know that exposure to HIV does not always result in infection. Persons with one or more other sexually transmitted diseases appear to be more likely to contract HIV through sexual contact.

Signs and Symptoms:

The incubation period can be both long and variable. Some people experience a brief flulike illness soon after infection, but most feel perfectly healthy and are likely to be unaware they have contracted HIV. After a period of several weeks (or even longer, in some cases), the body begins to make antibodies to the virus. Unfortunately, these antibodies cannot protect the body against HIV and its effects. They are useful for diagnosis, however. Once diagnosed with HIV, through the detection of the antibodies, the person is said to be HIV-positive.

At some point after becoming HIV-positive, the infected individual may begin to suffer such symptoms as:

• Chronically enlarged lymph nodes
• Weight loss
• Fatigue
• Diarrhea
• Unexplained fevers
• Night sweats
• This phase of the disease is called AIDS-related complex (ARC).

Diagnosis:

Generally, diagnosis is made through a blood test for the HIV antibody. If a person has HIV antibodies in his or her blood, this is proof that he or she has been infected. The doctor will also likely order a CD4 T-cell lymphocyte count to check for immune status.

He or she will likely refer you to an infectious disease specialist, where you will be tested for the most common forms of infection associated with HIV.

Treatment Options:

Antiretroviral treatments attempt to slow progression of HIV infection to AIDS, while antibiotics and other therapies are used to treat or prevent opportunistic infections and other complications as they arise. Alternative treatments may be used to support the immune system, help in coping with disease symptoms and side effects from conventional treatments, and improve quality of life.

Traditional Treatments:

• Your CD4 (white cell) count should be monitored at least every six months. Antiviral treatment is usually started when the count falls below 500 or when symptoms begin.
• Treatment of HIV infection itself is aimed at inhibiting the virus and keeping it from reproducing. Delavirdine (Rescriptor), didanosine (Videx), lamivudine (Epivir or 3TC), nevirapine (Viramune, or NVP), stavudine (Zerit, or d4T), zalcitabine (Hivid, or ddC), and zidovudine (Retrovir, azidothymidine, or AZT) are all drugs that inhibit the action of the enzyme reverse transcriptase, which plays a necessary role in the reproduction of the virus. Indinavir (Crixivan), nelfinavir (Viracept), tironavir (Norvir), and saquinavir (Invirase) are all drugs that block the action of another viral enzyme, protease. One problem with all the drugs used to suppress HIV is that the virus has the ability to develop resistance to them, often within a relatively short period of time. For this reason, combination therapy using two or three different drugs at once has become the preferred approach. All of the agents used against HIV can cause significant side effects.
• Another general approach to treating HIV involves efforts to "jump-start" the hematopoietic (blood-building) system, boosting the production of red or white blood cells to compensate for those destroyed by the virus. The drugs used for this purpose are expensive, and include epoetin alfa, filgrastim, and sargramostim. These therapies are usually reserved for the later stages of the disease.
• Specific infections should be treated promptly and aggressively, as they occur:
  Pneumocystis carinii, the most common opportunistic infection, is treated with powerful combination antibiotics, such as trimethoprim plus sulfamethoxazole. Other drugs may be tried, including dapsone and pentamidine. Aggressive oxygen and respiratory therapy may be needed in severe cases. Other complications may necessitate the insertion of an evacuation tube. This generally heals poorly and may require extensive intervention.
• Viral infections such as CMV may be treated with antiviral medications such as foscarnet or ganciclovir. These drugs are potentially quite toxic, and may only slow the progression of a viral disease rather than curing it altogether.
• For fungal (yeast) infections, such as oral thrush or yeast vaginitis, a doctor may prescribe an oral antifungal agent.
• Parasitic infections, such as giardiasis and cryptosporidiosis, along with viral, bacterial and amoebic infections, are all potential causes of enterocolitis, a common problem. An inflammation of the colon, this problem can affect anyone, but tends to be both more severe and more chronic in people with HIV. First, the offending organism has to be identified.
• Nausea, a common problem for HIV victims, is often a result of a yeast outbreak in the throat, so it is often treated with an antifungal medication. If that fails, an antiemetic may be prescribed.
• Loss of appetite and resulting weight loss are real dangers for people with AIDS. Besides nutritional counseling and the use of high-calorie dietary supplements, a variety of drugs may be used for this.
• Fever is a common problem. If no underlying infection can be found, standard antipyretics (fever-reducing drugs) are used.
• Diarrhea is usually treated with standard therapies but more aggressively than in healthy individuals.
• If a history of opportunistic bacterial or yeast infections is present, a lower dose, longer-term regimen of antibiotics may be prescribed as a preventative.
• Blood transfusions are not uncommon in advanced cases to increase the presence of infection-fighting white blood cells.

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, and improve overall health and well being.

Nutritional Supplementation:

• Take a high-quality multivitamin and mineral supplement daily.
• Black currant seed oil, borage oil, evening primrose oil, and flaxseed oil provide essential fatty acids (EFAs), which help to regulate endocrine function and also have anti-inflammatory properties. Choose one of these oils and take 500 to 1,000 mg twice daily. If diarrhea is a problem, discontinue until diarrhea improves.
• Bromelain is a natural anti-inflammatory and is very useful for respiratory complaints such as bronchitis and pneumonia. Take 400 mg three times daily, between meals.
• Carnitine supplementation can greatly improve the utilization of fat and the conversion of fats into energy, a process that is often compromised in people with HIV. L-carnitine is also useful in preventing toxic overload from such drugs as AZT. You may wish to discuss this supplement with a nutritionally oriented physician.
• Cat's claw may help to inhibit the reproduction of HIV while simultaneously activating the immune system. Take as directed with guaranteed potency products.
  Warning: Do not use cat's claw if you are pregnant, nursing, or are a recipient of an organ transplant.
• L-arginine, L-ornithine, L-cysteine, L-histidine, and L-methionine are important nutritional elements that enhance the immune system, retards the growth of tumors, protects against cancer, destroys free radicals, and aids in healing. Follow the label directions and take on an empty stomach.
• All of the carotenes have antioxidant properties that prevent free-radical damage. Take 75,000 to 100,000 IU of a carotene-complex formula daily.
• To insure full assimilation and utilization of all nutrients, take a full-spectrum digestive enzyme supplement providing 5,000 IU of lipase, 2,500 IU of amylase, and 300 IU of protease, plus 500 to 1,000 mg of pancreatin, with each meal.
  Warning: Long-term supplementation with pancreatin is not advised, as it can cause your pancreas to reduce its own production of this important enzyme. Over-use has the potential to cause nausea or diarrhea.
• If mouth sores are a problem, chew on folic-acid tablets. Take 400 mcg of folic acid up to three times daily this way.
• Garlic is a powerful immunostimulant that also aids in digestion, endurance, and strength. It is a natural antibiotic and is good for candida infections. Take 2 capsules 3 times daily with meals.
• Germanium helps to oxygenate tissues and is believed to contribute to interferon production. Take 200 mg each day.
• Take a green-foods or sea-greens supplement such as Green Magma or spirulina. Follow the label direction.
• Glutathione inhibits the formation of free radicals while aiding in red blood cell integrity and protecting immune cells. Follow the label directions and take on an empty stomach.
• Hydrochloric acid replenishes stomach acid and aids in digestion. Warning: Do not take hydrochloric acid if you have a history of ulcers.
• Inositol hexaphosphate enhances natural killer cell (anticancer) activity. Follow label directions.
• Lipoic acid fights herpes viruses, helps the liver function more efficiently, and is useful against chronic fatigue. Take 100 mg three times daily.
• Lycopene is a strong cancer preventer. Follow label directions.
• To control the proliferation of candida, take a quality probiotic supplement. Follow the label directions.
• To support immune function, consider taking adrenal spleen, and/or thymus glandular extracts. Take one dose, as directed on the label, twice daily.
• Selenium is a free radical scavenger and powerful immune enhancer. Take 400mcg daily. Warning: If you a pregnant, do not exceed 40 mcg of selenium daily.
• Take a trace-mineral formula that provides 5 mg of manganese, 200 mg of chromium, and 5 mg of vanadium daily. These elements are seldom included in common multimineral formulas.
• Studies suggest that HIV-positive people with sufficient blood levels of vitamin B12 may remain symptom-free for about twice as long, on average, as those who are deficient in that vitamin. Cobalamin is an active component of this essential B vitamin. Take 500 mcg of cyanocobalamin or methocobalamin twice a day, or ask your physician about injections. If you take any of the B vitamins individually, you should also take a B complex supplement at a different time of day.
• Shark cartilage inhibits tumor growth. Be sure to use 100% pure dried shark cartilage. Follow the label directions.
• Vitamin C is an infection-fighting, anti-inflammatory antioxidant vitamin that supports the immune system and also fights free radicals. Take 3,000 to 10,000 mg of vitamin C daily.
• Vitamin E is an antioxidant that also plays an essential role in cellular respiration. Choose a product containing mixed tocopherols and start by taking 200 IU daily, then gradually increase the dosage until you are taking 400 IU in the morning and again in the evening.
  Warning: If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily. If you are taking blood thinners, consult your doctor before taking supplemental vitamin E.
• Zinc boosts immune function. Take 15 mg three times daily, at the beginning of a meal.
• To maintain a proper mineral balance, you should also take 1 to 2 mg of copper each day.

Alternative Therapies:

• Aloe vera contains carrisyn, which appears to inhibit the growth and spread of HIV. Take 2 cups twice daily. Use a pure, food-grade product. If diarrhea occurs, reduce the dosage. Aloe vera is also good for mouth sores. Swish a mouthful of aloe vera juice around in your mouth several times daily.
• Astragalus boosts the immune system.
  Warning: Do not use astragalus if you have a fever.
• Burdock root, goldenseal, mullein, red clover, suma, and cayenne are good for cleansing the blood and lymphatic systems, for viral and bacterial infections, and for boosting the immune system.
  Warning: Do not take goldenseal on a daily basis for more than one week at a time. Do not take goldenseal during pregnancy. If you have a history of cardiovascular disease, diabetes, or glaucoma, use goldenseal only under a doctor's supervision.
• The seeds and peels of the Chinese cucumber inhibit cancer. The root is currently being used in AIDS research.
• For mouth sores, place alcohol-free goldenseal extract on a piece of sterile gauze and apply the gauze between the lips and gums or to mouth sores before going to bed. Leave it on overnight. Sores and inflammation should heal in a few days with this treatment.
• Licorice and wild yam root are good for endocrine gland function.
  Warning: Do not use licorice on a daily basis for more than seven days in a row. Avoid it completely if you have high blood pressure.
• Magnolia vine berries increase oxygen absorption and boost the immune system.
• Pau d'arco is a natural antibiotic and helps immune function. It is also a powerful antioxidant and is good for destroying candida in the colon.
• St. John's wort contains substances that inhibit retroviral infections and could be useful in the treatment of AIDS.
• Siberian ginseng helps bronchial disorders and boosts the immune system.
  Warning: Do not use Siberian ginseng if you have hypoglycemia, high blood pressure, or a heart disease.
• Take ginger or peppermint tea with meals to combat nausea and enhance digestion.
• Turmeric contains curcumin, a natural anti-inflammatory. Take 500 mg twice a day.

General Recommendations:

• If you test positive for HIV, arrange for repeat testing as soon as you can to rule out the possibility of a false-positive.
• Avoid stress as much as possible. Experiment with meditation and relaxation techniques.
• Get regular, adequate sleep.
• Avoid exposure to pollutants and toxins.
• Avoid excessive sun exposure and extremes of temperature.
• If you become pregnant, seek medical treatment immediately. There are drugs that can minimize your risk of passing the infection on to your child. Prenatal care is doubly important for women with HIV and their babies.
• Try to avoid coming in contact with people who have contagious illnesses.
• Practice careful personal hygiene.
• Seek out sources of support such as counseling or membership in a support group.
• Pay special attention to meeting your nutritional needs and requirements, and keep in mind that a higher than normal intake of nutrients will probably be necessary.
• Exercise caution in your choice of foods so as to avoid exposure to food borne illness. Food poisoning can be very dangerous for people with HIV or AIDS infection.
• Do not smoke and avoid second hand smoke.
• Avoid alcohol, noxious chemicals, and anything else that can damage the liver.

Warnings:

• Echinacea is an immune stimulant and should be avoided. It stimulates replication of T cells, which in turn enhances replication of the virus.
• Long-term supplementation with pancreatin is not advised, as it can cause your pancreas to reduce its own production of this important enzyme.
• Do not take hydrochloric acid if you have a history of ulcers.
• Do not use cat's claw if you are pregnant, nursing, or are a recipient of an organ transplant.
• If you a pregnant, do not exceed 40 mcg of selenium daily.
• If you have high blood pressure, limit your intake of supplemental vitamin E to a total of 400 IU daily.
• If you are taking blood thinners, consult your doctor before taking supplemental vitamin E.
• Do not use astragalus if you have a fever.
• Do not take goldenseal on a daily basis for more than one week at a time.
• Do not take goldenseal during pregnancy.
• If you have a history of cardiovascular disease, diabetes, or glaucoma, use goldenseal only under a doctor's supervision.
• Do not use licorice on a daily basis for more than seven days in a row.
• Avoid licorice completely if you have high blood pressure.
• Do not use Siberian ginseng if you have hypoglycemia, high blood pressure, or a heart disease.