EFFECTS OF VITAMIN-E AND VITAMIN-C SUPPLEMENTATION ON OXIDATIVE STRESS AND VIRAL LOAD IN HIV-INFECTED SUBJECTS

Objectives: The HIV-infected population is known to be oxidatively str essed and deficient in antioxidant micronutrients. Since in vitro repl ication of HIV is increased with oxidative stress, this study assessed the effect of antioxidant vitamin supplementation on lipid peroxidati on, a measure of oxidative stress, and viral load in humans. Design: A randomized placebo-controlled, double-blind study. Methods: Forty-nin e HIV-positive patients were randomized to receive supplements of both DL-alpha-tocopherol acetate (800 IU daily) and vitamin C (1000 mg dai ly), or matched placebo, for 3 months. Plasma antioxidant micronutrien t status, breath pentane output, plasma lipid peroxides, malondialdehy de and viral load were measured at baseline and at 3 months. New or re current infections for the 6-month period after study entry were also recorded. Results: The vitamin group (n = 26) had an increase in plasm a concentrations of alpha-tocopherol (P < 0.0005) and vitamin C (P < 0 .005) and a reduction in lipid peroxidation measured by breath pentane (P < 0.025), plasma lipid peroxides (P < 0.01) and malondialdehyde (P < 0.0005) when compared with controls (n = 23). There was also a tren d towards a reduction in viral load (mean +/- SD changes over 3 months , -0.45 +/- 0.39 versus +0.50 +/- 0.40 log(10) copies/ml; P = 0.1; 95% confidence interval, -0.21 to -2.14). The number of infections report ed was nine in the vitamin group and seven in the placebo group. Concl usion: Supplements of vitamin E and C reduce oxidative stress in HIV a nd produce a trend towards a reduction in vital load. This is worthy o f larger clinical trials, especially in HIV-infected persons who canno t afford new combination therapies. (C) 1998 Lippincott Williams & Wil kins.