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Bottom Lines

November 2001

There's More to Good Health than Viral Load and T-Cell Count

Research continues to point to the benefits of improved diet, stress reduction, and exercise in HIV-infected people. One recent study, published in Clinical Infectious Diseases (33, p. 710, 2001), looked at the dietary habits of 85 HIV-infected men and women with symptoms of lipodystrophy. Each person was evaluated for dietary intake of alcohol, fiber, and fats; waist-to-hip ratio; body mass index; pattern of body fat changes; use of protease inhibitors (and for how long); and basic characteristics like age and sex. The researchers examined these traits to see if there was a relationship to problems like insulin resistance, which can lead to diabetes. Although the use of protease inhibitors increased the risk of insulin resistance (as other studies have shown), factors like a diet high in polyunsaturated fats or low in fiber were independently associated with insulin resistance. Also, alcohol consumption was tied to increased levels of LDL ("bad") cholesterol. The researchers suggest that dietary factors may contribute to the metabolic disturbances experienced by many people with HIV. They believe that clinical trials are needed to see if altering dietary habits can help improve symptoms of lipodystrophy in HIV-infected people.

A second study, in the journal Proceedings of the National Academy of Sciences (98:22, p. 12695, 2001), points out that stress may lessen the effectiveness of anti-HIV medications. The scientists measured characteristics like blood pressure, heart rate, and skin moisture (sweating) in 13 HIV-infected men who had never taken protease inhibitors. The men were divided into 2 categories: low stress and high stress, based on their characteristics. After starting these patients on highly active antiretroviral therapy (HAART) containing a protease inhibitor, the researchers found that individuals with higher stress levels tended to have detectable viral loads and smaller increases of T cells. Those with low stress levels mostly had undetectable viral loads and greater increases of T cells. Also, in cell cultures, the researchers found that the human hormone norepinephrine, which is produced in the body during times of stress, increased rates of T-cell infection and HIV reproduction.

Bottom Line: HIV can dominate your health concerns, causing you to lose sight of important factors like diet, exercise, and rest. Nutritionists, personal trainers, and mental health counselors can help you make key changes to improve your overall health -- and this might help your body fight HIV even better. Remember that there's more to good health than viral load and T-cell count.

The Intriguing Story of the Viruses and Bacteria that Live Within Us, Balancing our Immune System

Two reports in The New England Journal of Medicine (345:10, pp. 707 & 715) indicate that infection with a virus called "GB virus C" (or hepatitis G) may slow down HIV disease progression, thus improving survival in HIV-infected people. GB virus C (GBC) is not associated with any known disease. In one report, 144 out of 362 HIV-infected patients were co-infected with GBC. During the follow-up period, only 28.5% of patients with both viruses died, while 56.4% of patients with just HIV died. In cell cultures, the researchers found that cells infected with both HIV and GBC produced 30% to 40% less HIV than cells infected with HIV alone. The other report found that in a group of 197 HIV-infected patients, individuals with GBC had significantly longer survival time and a slower progression to AIDS. The researchers believe that further study of GBC may lead to new developments for the treatment of HIV disease.

On a related note, scientists studying human cell cultures have discovered that human herpesvirus 6 (HHV-6) may influence the course of HIV infection by inhibiting "CCR5-tropic HIV," a type of HIV that is active during early infection. The study, published in Nature Medicine (7:11, p. 1232, 2001), offers hope that drugs or vaccines can be developed to fight HIV in new ways.

Bottom Line: Viruses and bacteria exist in all our bodies -- usually in balance with a healthy immune system. Early research showing that certain viruses may improve survival for people with HIV is good news that must be studied in clinical trials. These reports do not immediately apply to people with HIV but do provide some hope.

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