Effect of N-acetylcysteine(NAC) treatment on HIV-1 infection: a double-blind placebo-controlled trial.
OBJECTIVE
In a double-blind placebo-controlled trial, human immunodeficiency virus (HIV)-seropositive patients with a CD4 lymphocyte cell count of more than 200 x 10(6) . l-1 were randomised to receive either 800 mg N-acetylcysteine (NAC) or placebo for 4 months. Before treatment low plasma cysteine levels, high free radical activity in neutrophils in the presence of autologous plasma-measured by the nitroblue tetrazolium (NBT) test- and increased tumor necrosis factor (TNF)-alpha levels were found in the HIV positive patients.


RESULTS
After treatment the low plasma cysteine level in the NAC group increased to normal, and the decline of the CD4+ lymphocyte count before the study start, was less steep in the NAC group than in the placebo group after treatment. There was also a reduction in TNF-alpha level. However, NAC had no effect on the radical production by neutrophils, and although it did not increase the CD4+ cell count, it may have decreased the decline in CD4+ cells.


CONCLUSIONS
Further controlled trials with NAC are needed to determine whether it has a beneficial effect in the treatment of asymptomatic HIV-infected individuals.
Akerlund
B
B
Department of Infectious Diseases, Karolinska Institute, Huddinge Hospital, Sweden.
Jarstrand
C
C
Lindeke
B
B
Sönnerborg
A
A
Akerblad
A C
AC
Rasool
O
O
D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003545:Cysteine / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D009580:Nitroblue Tetrazolium; D013481:Superoxides / Q000032:analysis; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000998:Antiviral Agents; D016166:Free Radical Scavengers; D014409:Tumor Necrosis Factor-alpha; D013481:Superoxides; D009580:Nitroblue Tetrazolium; D003545:Cysteine; D000111:Acetylcysteine