Micronutrients for Living Well with HIV- Part 2 of 3

Published 17, Aug, 2010

To build health from within, it is important to understand inflammation and oxidation. Inflammation is believed to be one of the main causes of aging and organ disease in PHAs.

To build health from within, it is important to understand inflammation and oxidation.Inflammation is believed to be one of the main causes of aging and organ disease in PHAs.

In the early 80’s there was on going research in gut associated lymphoid tissue (GALT).Researchers knew in early HIV infection, the immune cells in the intestinal system are infected and the early symptoms of HIV seroconversion are gastrointestinal (GI) related diarrhoea, wasting, indigestion, and weight loss. However, when the triple combination anti-HIV drugs came about in 1996, research in GALT was abandoned until recently in 2006 it resurfaced (http://www.prn.org/index.php/progression/article/hiv_1_gastrointestinal_galt_267). In the last five years, researchers have found that ARV has revived some of the immune cells in the intestinal system but not all of it.Plus there are many variables; number of CD4+ cells at time of ART initiation, CD8, percentage of CD4+ ,other co-infections, and overall health.

HIV infection in the GI tract can affects absorption of foods and nutrients in the intestines. “To maximize the efficiency of digestive function, the GI tract has evolved such that it has the largest surface area among all organs. In fact, the 400 m2 surface area of the GI tract is about 200 times larger than the surface area of the entire skin.”(Mehandru.S, 2007). We know HIV also affects the production of B12 in the intestine hence many PHAs are B12 deficient. B12 is important for energy and red blood production. Furthermore HIV infection affects the bone and heart muscles. A health regimen has to integrate the many components of health. As such taking antiretrovirals therapy (ARV) is one part of the plan but not all of it.

Thirty years later, HIV is known to cause many cellular inflammations, from an increase in cytokines, chemokines, interleukins, an imbalance in the two arms of the immune system; the cellular and humoral arm to mention a few. As all of us know our body best, but how do we control inflammation within and keep our health at an optimal level. There is much more one can do to boost cellular health, minimize oxidative stress while living with HIV infection. We are going to take a look at what goes on in the cells and understand inflammation, oxidation and the role of the mitochondria.

The immune system and inflammation: Living with HIV infection means the immune system is constantly activated or stimulated and does not get the vacation it needs. While a person may have a high CD4+ count, the CD8 may also be high which means the immune system is constantly fighting off the infection. In an ideal immune system, it has high CD4+ and low CD8 count. A low viral load or undetectable viral load does not mean HIV is not in the tissues, cells, blood or organs. All it means is HIV cannot be detected by the current diagnostic test.  Over the cause of HIV infection, we are now certain of the increase in inflammation over a long term in living with HIV. The cause of this increase is not completely understood.

When the body is fighting an infection, “or repairs injured tissues, fluids and cells get transported to the site of injury. As the body heals, the cells can swell, get warm, and become sore. One theory is that as HIV chronically infects the body, cells and tissues are destroyed and then heal, activating the immune system. That leads to an over stimulated immune system that can become burned out or weakened. So, even though a lab result may show a high CD4 count, the amount of inflammation in the body may be causing damage on a cellular level. And that can lead to heart, liver, kidney disease, and greater levels of bone loss."For more on HIV and inflammation, http://www.thebody.com/content/art57904.html?ic=700100.

What is oxidation?

Oxidation is a process of breaking food down into energy and involves a chemical reaction. Food breakdown is one of the many oxidative processes in our bodies. During this process, molecules called free radicals are produced. Free radicals are a normal part of the oxidation process. They can damage the membranes of the cells in much the same way that rust damages the body of a car.

During HIV infection, many researchers have observed an increase in free radicals (extra unpaired oxygen molecules, oxygen has two molecules as in O2, in its stable form). ARV and HIV infection both seem to cause an increase in free radical production in the body and this is currently believed to be linked with inflammation.What can you take to minimize oxidation? Increase the intake of anti-oxidants either with foods and/or supplements, and improve your breathing capacity.

Mitochondria, is located in the cells and is the energy production centre of the cell. They are tiny thread like organelles in living cells-they squirm, lengthen, and change shape almost continuously. Enzymes dissolved in the fluid within the mitochondria, carry out reactions in which oxygen is used to break down food. As foods are broken down, energy is released. Some of the fatigue reported in HIV infection, is related to mitochrondria toxicity. Mitochrondria is found in almost all organs, tissue, nerves, and bones muscles in the body. While ARV are important to control viral replication ,it also can damage mitochondria DNA and cells, and cause wide range of side effects including fat loss, peripeheral neuropathy, and high lactate levels amongst a host of symptoms.

The free radical production causes mitochrondia toxicity and cell death (apoptosis). Some research has associated free radical with side effects such as neuropathy, acid lactosis, pancreatitis (Dr. Jon Kaiser, 2003). Inflammation is an ongoing process as long as HIV exists in the body. The inflammation is directly linked with illness associated with aging such as bone loss, cardiovascular disease and decrease in cognitive functions.

What we do know is one potent antioxidant can decrease the impact of free radicals. It is called glutathione, and it is very effective as minimizing the oxidative process at an intracellular level in the cells. Our body in its inherent wisdom produces glutathione in the walls of our cells. Some foods can also minimize inflammation in the body. These will be discussed in Part 3.Translate