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Chester Myers' Nutrition Series Information relating to HIV & Nutrition: HIV & The Gut Good nutrition is extremely important if you are HIV+. The information here deals with only one aspect of good nutrition.
OHL isn't considered a major hazard. Some doctors use a tincture of Podophyllum on OHL. Use of antioxidant supplements may be of benefit (Kaugars et al, 1993), although this may be of a general nature since antioxidants are generally important for immune function (i.e., use of antioxidant supplements is advisable even in the absence of OHL). Aphthous ulcers can be painful, destroy your enjoyment of food, and should always be treated by a medical doctor. Rinsing and gargling with either a salt solution, 1-3% hydrogen peroxide, a few drops of NutriBioticsTM in a tablespoon of water, or a few drops of Te Tre oil in a tablespoon of water can help in some cases, but should not be relied upon without also seeking expert medical advice. Corticosteroids have been prescribed for aphthous ulcers, but these should be used with caution since extensive use may make other opportunistic infections more likely (Nelson et al, 1993). There are now reports that use of thalidomide may help healing of aphthous ulcers; there are also other good reports on this drug (Alexander et al, 1997; Jacobson et al, 1997; Klausner et al, 1996; Makonkawkeyoon et al, 1993; Paterson et al, 1997; Sampaio et al, 1993; Soler et al, 1996). There are several ways to discourage thrush in your mouth and throat. Thrush grows fastest on simple sugars, so avoid foods with high levels of these (simple sugars may be listed on the label's ingredient list as sucrose, glucose, fructose, and other names ending with 'ose'). After you've eaten, brush your teeth. Then, it's good to rinse your mouth so there will be no food particles left. The products listed above, such as Te Tre oil, can be used as a gargle and mouthwash. NutriBioticTM (also called CitricidalTM) may also be effective at helping prevent yeast infection. Don't use at full strength - remember, only a few drops (5-10) in a tablespoon of water - if it irritates your mouth, then you may be using it too strong. You can swallow this afterwards if you don't mind the taste. This material comes from grapefruit seeds, and helps control thrush and bacterial infections. If you choose to use hydrogen peroxide (1-3%), spit this out after gargling since it's dangerous to swallow. If for whatever reason, you find you are eating foods with high levels of simple sugars, it may be useful to take an antifungal such as Diflucan as a preventative. Get to your doctor if you develop a yeast infection. [High levels of simple sugars may also be immunosuppressive (Bernstein et al, 1977; Caderni et al, 1997; DeStefani et al, 1997; Sanchez et al, 1973).] The oesophagus This is a muscular tube that pumps the food you've chewed down to your stomach. The oesophagus is lined with a soft wet material that also is an important part of your immune system. This mucosal lining contains compounds, called immunoglobulins, especially one called secretory immunoglobulin A (sIgA). These help you fight disease. This tube is part of your digestive system AND part of your immune system - it's very important to keep it healthy. The lining of your oesophagus can get infected with the yeast candida. This infection, called oesophageal candidiasis, makes it difficult, even painful, to swallow food, and is dangerous. If you suspect you may have this, it's important to check in right away with your doctor who can give you treatment for it. Never rely on home remedies for oesophageal candidiasis. To make your oesophagus a more difficult place for candida to invade and grow, you can again do some things to help. One way is to use the NutriBioticTM liquid diluted as above as a gargle and then to swallow this so it washes down the oesophagus mucosal lining. You can also suck on NutriBioticTM tablets several times during the day. Eating foods with garlic, olive oil or coconut oil can also make it more difficult for candida to grow. Finally, keep the sugar content of your food low; sugar is the yeast's favourite food. But even so, never rely on these to cure candidiasis - see your doctor at once! If you have pain when you swallow, your doctor may say that you have odynophagia. If you have difficulty in getting your food from your mouth to your stomach, your doctor may say you have dysphagia. There may be various causes of these, such as cytomegalovirus (CMV), sporidial parasites, or Kaposi's sarcoma (KS). Heartburn, another type of pain, can result when acid from your stomach 'burps' up into your oesophagus (Raufman, 1988). This doesn't necessarily mean you have too much stomach acidity (the opposite seems to be more likely with HIV infection). For some people, lying down flat may encourage heartburn since it makes it easier for the stomach acids to burp up - so try keeping the upper part of your body elevated if you lie down when you have heartburn. Sipping water or flat Coke may also be helpful. Since the lining of your oesophagus is part of your immune system, it may also be a place that the HIV attacks. It's difficult to know for sure how to make this less likely; however, we know that certain foods contain compounds that have antiviral properties. These compounds are usually also antioxidants which may also give other benefits. The idea of compounds in foods that may have direct antiviral properties is interesting. Pessimists will probably argue that it is only hypothetical that food compounds with antiviral properties might help fight HIV infection; they will probably also argue that we don't know whether these compounds can be absorbed into the body from the gut at levels sufficient for their antiviral properties to be significant. The important thing to remember is that the lining of your intestinal tract is a major reservoir of T-cells, and that your food has direct contact with this lining even if these compounds are not absorbed. Surely it's only common sense to help keep your gut healthy. What compounds then, might be helpful? There are certain classes of compounds in various vegetables, fruits, and seeds or leaves of various plants, that have been shown to have antiviral properties (Barnard et al, 1993; Li et al, 1993), as well as other helpful effects (Duarte et al, 1993; Galvez et al, 1993, Hertog et al, 1993; Jarhomi et al, 1993; Tournaire et al, 1993). Some of the studies have included HIV (Kreis et al, 1990; Schols et al, 1991; Mucsi et al, 1992; Li et al, 1993). In general, these compounds are pigments, that is, the materials that give colour to your natural foods. They may be called phenolics, flavonoids, flavonols, anthocyanins, leucoanthocyanins, etc. They even include compounds (gallic acid, caffeic acid, and chlorogenic acid) found in foods such as sunflower seeds, brightly coloured vegetables (broccoli, carrots, squash, spinach, tomatoes, etc.), regular tea, onions, garlic, many vegetables and herbs. They also include antioxidants such as quercetin that are likely unfriendly to the HIV. For example, caffeic acid, found in sunflower seeds, and some derivatives of it have been shown to kill HIV in the test tube. Chew up foods containing these compounds well and swallow them, so that some of these antiviral compounds may get in contact with the oesophageal lining and hopefully make it difficult for the HIV to invade. Remember every little bit may help. Turmeric in casseroles and other food preparations, regular tea, and teas suggested by a practitioner of Traditional Chinese Medicine are all likely to contain compounds that may be worthwhile since these come in contact with the lining of your gut on their way through you (Kreis et al, 1990; Schols et al, 1991). The stomach In your stomach, the food you've just chewed gets mixed in with acid to help break it down to smaller units that your body can absorb and use to gets its nutrition and energy. This mixture of food, acid and enzymes is called chyme. Remember that there are enzymes added to your food in your mouth so that both the fats (speculative) and carbohydrates (known) of your food start to get broken down as you chew. In your stomach this breakdown continues, although, as the stomach acid mixes with the bolus of food received from the mouth via the oesophagus, the salivary enzyme that helps digest starch is killed off fairly rapidly. Protein also starts to get broken down by the stomach acidity. There is very little of your food that gets absorbed into the body from your stomach. Some copper gets absorbed here, and if you drink alcohol it also gets absorbed from your stomach into the rest of your body. Your body has a mechanism that tries to keep your food from continuing on its journey to the next section until the fat has been broken down; however, your food may still go to the next section without the fat being fully broken down. Thus, some food may be retained in the stomach up to 3 or 4 hours after eating before it goes on to the next section. Release from the stomach is through a valve called a sphincter (the pyloric sphincter). Some problems that can happen to the stomach when you are HIV+ may be from a decrease in the stomach acidity so that your food is more difficult to digest. Some people use either glutamic acid hydrochloride or betaine hydrochloride supplements to increase stomach acidity when they eat. Digestive enzymes such as Daily Essential Enzymes may help improve digestion since these don't require high acidity, and can help the breakdown of your food. If you use enzyme supplements, it's probably best if the supplement contains enzymes that digest protein, fat and carbohydrate; some supplements contain only enzymes that break down protein. Even taking an acidophilus supplement with your meal may aid digestion. My personal experience has been that, of the commercial enzyme supplements, a brand that works well with one person doesn't necessarily work as well with others; hence, you may need to try different brands if you are to give them a fair try. The small intestine The contents of your stomach next go to your small intestine, and it is here that most digestion and most absorption of the resulting nutrients into your body occurs. The acid from the stomach is neutralized. The broken down products are absorbed into your body to be used to produce energy, heat, and materials for your immune system. Absorption is considered to be a main function of your small intestine. Your small intestine is a very long narrow tube, about 6 metres long, that is coiled into the space beneath your stomach. The surface area of this section of your gut is its largest, and is important to ensure good absorption of your nutrients. Your small intestine is connected to several other important parts of your body - the gall bladder, the pancreas, and your liver. The lining of your small intestine is not at all smooth. Instead, it's made up of many thousands of very tiny 'fingers' so that there is a huge surface area to make sure the broken down products from your food are efficiently absorbed into the rest of your body. If you were to look at these fingers with a microscope, they would look a little bit like what you see when you look at the ends of the bristles of a paint brush. Because these 'fingers' are so small, yet do so much work absorbing your food, they keep getting worn down and must repair themselves at a fast rate. In general, they must completely rebuild themselves about every three days - so you see, the food you eat must also supply the building blocks to ensure the continual rebuilding of this part of your digestive system. The amino acid glutamine and thiols (sulfur-containing compounds such as N-acetyl cysteine) are of special importance for maintenance of the gut lining. Your small intestine is also another important part of your immune system called the gut associated lymphoid tissue (GALT) - the respiratory and urogenital tracts also have similar mucosal linings that have important immune functions (Stites & Terr, 1991). The small intestine is lined with a mucosal system that provides a reservoir of T-cells called the "mucosal T-cells" (the T-cells in your blood are called the "systemic T-cells"), and the number of these is major! (Beagley & Elson, 1992). They are not measured by normal (blood) tests! Along the small intestine are sections called "Peyer's patches", also part of your immune system. That the small intestinal lining is a reservoir of T-cells is only one reason why it is also a site of attack by HIV. Although HIV infection might directly cause problems, it seems that this is usually not the case. Obvious problems seem to result mostly from other infections (Smith & Mai, 1992). Just as with your oesophagus, I believe you can help give some protection also for your small intestine by eating those foods high in antioxidants and other antiviral materials (see the above section on the oesophagus). There are several problems that can occur with your small intestine. With HIV, the 'fingers' lining the walls can get worn down to a short length because of too little nutrition. This makes it even more difficult to get your nutrition since it decreases the effective surface area for absorption of your nutrition - a sort of Catch-22 situation. Several studies indicate that deterioration of the small intestine lining may be the earliest result of HIV infection, even before T-cells decline (Batman et al, 1989; La Brooy, 1993; Ott et al, 1993; Ullrich et al, 1989). I believe that a large cause of this problem is that HIV decreases the body's thiols, and makes you use up your vitamins and minerals at a very fast rate. If you don't make sure you get more vitamins/minerals than usual, then your body loses its normal ability to keep itself repaired. We know that vitamins B6 and B12, and the minerals magnesium and zinc are used at a faster than normal rate with HIV disease. Since these are very important for your body's ability to keep itself repaired (including replacement of the 'fingers' along the walls of your small intestine), you must make sure you keep these nutrients at a good level in your food and vitamin supplements. Several studies indicate that you are unlikely to obtain enough vitamins and minerals from even an excellent diet of food, and therefore vitamin supplementation should be considered essential for anyone who is HIV+. A good multivitamin with minerals is a good place to start. To get a good balance, if you choose one that contains at least 25 mg (milligrams) of vitamin B6 (preferably with about 1.5 - 2.5 mg in the phosphate form), 400 mcg (that's micrograms) of folic acid or folacin, 50 mcg of selenium, 50 mcg of molybdenum, then likely the rest of the vitamins and minerals will be in balance. In addition, extra zinc (about 50 mg a day), and extra vitamin B12 by a non-stomach route (such as by injection or an under-the-tongue tablet) are important. At the same time, oxidation caused by the virus decreases levels of the important amino acids cysteine and methionine, important for many things including repair of the lining of the small intestine. N-acetyl cysteine (NAC), at 1000-1800 mg/day, may help alleviate this. You can get infection in your small intestine. When this occurs, your doctor will likely say that you have Small Bowel Disease (SBD) or Inflammatory Bowel Disease (IBD). S/he may also use names such as ulcerative colitis or Crohn's disease. Infection with parasites may also be a cause of small bowel problems. It's important to follow your doctor's instructions so it will get cured as soon as possible. S/he may give you antibiotics if s/he suspects a bacterial infection. (Normally, high stomach acidity prevents infection from entering the small intestine from the stomach; if the stomach acids are low, this protection is decreased.) In any case, remember that a diagnosis of inflammation of the small intestine likely means that absorption of your nutrients is severely limited. Sometimes the fat in your food doesn't finish breaking down in the small intestine, and you may even need to decrease the amount of fat in your food. Another reason to decrease dietary fat content would be diarrhea that is difficult to get rid of. However, be careful not to eliminate too much fat from your diet - unless you absolutely have to - since many people don't get enough calories from fat when they have HIV. Fish fat may be preferable to other types of animal fat, but keep the percentage of your calories from most regular animal and plant fats under about 20%; otherwise, rely on coconut fat or MCTs (medium chain triglycerides) for calories in excess of this 20%, but keep total calories from fats under about 30-35% of your calories. If serum triglycerides are high, you should keep all fats other than coconut or MCTs down to about 5%-10% of your total calories: some have recommended fat contents as low as 3% of total calories. Essential fatty acids are important to maintain, so that some vegetable oils are needed. About 2 teaspoons per day of soy, corn, and similar oils is sufficient to supply this (but high levels are immune suppressive! see more on this issue in HIV and Liquid Food Supplements, another monograph part of this series Information relating to HIV & Nutrition). Supplemental enzymes with your food may help digest the fat in your food. Enzymes that do this are called lipases. In addition, carnitine is a compound the body requires to make use of fat. This tends to decrease in HIV infection. It is available in the diet only from red meat. Your body can make it if it has the starting materials, lysine, methionine (vitamin C is also required). It may be a good idea if you are a vegetarian to take supplemental carnitine. Levels up to 2-4 grams per day are-non-toxic, while levels above 6 grams may cause diarrhea (each person needs to determine their "bowel tolerance level" if gram quantities are being taken). Carnitine may be of extra importance for those with high levels of serum triglycerides. The amino acid glutamine is also important for providing the intestines with energy (Hunt & Groff, 1990), as well as for general energy production. Although glutamine should be synthesized in the body as well as being readily available in a balanced diet, some people also try to get extra glutamine in special food formulations. Eggs are a good source. The large intestine The large intestine is 'in line' after the small intestine, is about 1.5 metres long, and receives remaining material from the small intestine through another valve, called the ileocecal valve. The large intestine is made of sections, each called a colon, but with different words (ascending, descending, transverse) to describe the different sections. Although shorter in length, the large intestine is larger in diameter, yet still with a smaller surface area than the small intestine. One function of your large intestine is absorption of minerals. Absorption of liquid from your food also occurs so that the remaining unabsorbed material becomes solid (your stool). However, your large intestine is very important also for other reasons . While the part of the small intestine immediately after the stomach should be more-or-less sterile (i.e., few bacteria grow there), the later part and the large intestine are sterile only for the first few days after birth, and then become populated with many friendly bacteria, even perhaps some friendly yeasts, that are important for your health (Finegold & George, 1989). These friendly 'flora' produce vitamins, short-chain fatty acids important for your health (such as controlling cholesterol), and help prevent unfriendly infectious bacteria and yeasts from developing - i.e., an indirect sort of immunity. It's interesting that Mother Nature gave us this natural protection. While the mouth, throat and oesophagus are a bit more vulnerable, the stomach receives protection from its acid which helps kill organisms in your food, and this helps to also protect the small intestine. [One reason not to eat large quantities of sugar is so yeast cannot easily get its favourite food in your mouth, throat and oesophagus where the only direct protection is provided by the immune system. Keeping your carbohydrate in a complex form will restrict high sugar levels from these parts. They are liberated from the complex carbohydrate and other parts of your food in the lower part of the digestive system which is better protected.] The small intestine also has many enzymes that likely also help prevent infection. In the large intestine, the friendly flora are your 'front line' fighters to protect this part of you from infection. You may not want high levels of simple sugars in your mouth or oesophagus; however, in your intestines, you will have moderate levels of sugars since these are produced from your food by the digestion that occurs in your stomach and small intestine - they are essential since they provide energy for you. So it's important to keep the friendly flora healthy to help prevent unfriendly yeast from growing on this sugar. When we talk about the "friendly" flora of the large intestine, "Lactobacillus acidophilus" is the best known, and is usually called simply "acidophilus". When we refer to supplements that help replenish these gut flora, we often refer to them as "acidophilus", although we usually really mean a mixture of friendly bacteria. Only a few are available as supplements since some of the others are 'friendly' only in the large intestine and may not be friendly in the mouth, oesophagus, stomach, and small intestine. In any case, once you get these "few" friendly bacteria into your system, this makes it easier for the other friendly bacteria to exist at a good level in your large intestine. The next best known of the friendly flora are the "bifidobacteria" which have been associated with reduction in certain types of cancer. Some claim this is from enhancement of certain immune functions (Hoover, 1993; Ishibashi & Shimamura, 1993). While we don't know what many of the gut 'bugs' prefer as food, the bifidobacteria are known to grow on a dietary fibre called inulin found in foods such as leeks, onions, garlic, asparagus, bananas, Jerusalem artichoke, chicory, and some other vegetables. There are several problems that can occur in your large intestine with HIV. It can get infected with unfriendly bacteria, yeast, or parasites. These can cause problems even for someone without HIV. When you have HIV, this can still happen, and it is even more important to get medical attention to get rid of them. However, there are several others, called opportunistic since they strike only when your immune system has been weakened. A mycobacteria, the infection called MAC or MAI, can get into this part of your body as well as other parts. Some viruses can also infect the intestine. Some of these can give you diarrhea, sometimes accompanied with fever. Make sure you immediately see your doctor to get tested to see what is wrong if you have diarrhea. (Remember that some drugs may cause diarrhea, so don't panic; just make sure you find out what is the cause. Some doctors believe that HIV can also cause diarrhea directly, but don't let this keep your doctor from thoroughly checking for any other cause - again, a gastroenterologist experienced in HIV disease is advisable for consultation, and even suggest this to your doctor if s/he hasn't already suggested it to you.) The longer you leave infections untreated, the more difficult it may be to treat them. Again, keeping a healthy diet and making sure your friendly bacteria are healthy and plentiful should make it more difficult for these unfriendly 'bugs' to infect your large intestine. Your large intestine also has a mucosal lining that is part of your immune system (pardon me for emphasizing this ad nauseam, but I happen to feel strongly that a large part of living long and living well with HIV is having a healthy gut!). Since the function of the mucosal lining of your gut is still poorly known, it's better not to take chances, and consider this as another reason to do everything you can to keep your large intestine healthy. If you use colonics (douching), you may flush out minerals that would otherwise be absorbed. Also, some of your friendly gut bugs may be flushed out. If you do extensive anal douching, for whatever reason, it may be worthwhile to take a supplemental multimineral in addition to your multivitamin with minerals, and extra supplemental acidophilus (make sure it also contains bifidus). The rectum Not all the food you eat is used by your body for nutrition. Some of it is unused, and after being solidified in the large intestine is eliminated from your body. For this function of elimination, the anal canal and rectum should be maintained as healthy as possible. Since anal sex is common in the gay lifestyle, it's also important to keep the anal canal and rectum healthy for your enjoyment (within the confines of safer sex!). Your rectum may also get infections. Soreness or itching may be a sign something is wrong. It may mean simply that you have hemorrhoids, enlarged veins in the anal canal, but even so, make sure your doctor checks it out. Even hemorrhoids should be treated since the irritation from them will make other infections easier to set in. Treatment for hemorrhoids may be nothing more than sitting in a tub of warm water for a period of time for a few days. Constipation can be irritating for inflammation in this area. Keeping vegetables and other sources of a variety of dietary fibres in your diet helps to prevent this. Making sure you have enough magenesium is also important. Green leafy vegetables, nuts and seeds are food sources of magnesium, but a daily supplement of from 200 to about 800 mg of magnesium should be considered. In any case make sure your doctor monitors your serum magnesium levels. In some cases, detection of low calcium by your doctor may cause someone to suggest you take high levels of calcium supplementation which may cause an imbalance with magnesium and therefore constipation. In some cases, especially for people taking pentamidine, it has been noted that low calcium may result from low magnesium, and in this case it's magnesium supplementation that may be important - i.e., the calcium deficiency goes away when you get more magnesium. Although magnesium may be higher in salad greens, make sure you don't decrease your intake of high calorie foods. In fact, a knowledgeable dietitian (Jensen, 1993) who has done a lot of study of the issues regarding HIV infection cautions against filling up on salads, even to the extent of avoiding them completely, because they contain few calories (energy). While I believe that salads have important components in them that can be useful, these components may be better if taken as supplements (magnesium, bioflavonoids) which don't fill you up, or as juices made from fresh washed vegetables and/or berries. However, if you are maintaining your weight, and have no problem with diarrhea, then a 'normal' salad intake seems to be reasonable (PROVIDED ALL SALAD materials are cleaned and sterilized by APPROPRIATE WASHING). Finally, if you try to add up how many kilograms of food you eat in a year, perhaps this will also help convince you that your digestive system must do a lot of work for you and deserves your best care. My final personal comment: I strongly believe that a major difference between long-term survivors and those who succumb quickly to HIV is that the long-term survivors have, for whatever reasons, maintained a healthier gut system. This document attempts to describe only a few of the means of maintaining a healthy gut system, even with HIV infection. References LN Alexander, CM Wilcox, "A prospective trial of thalidomide for the treatment of HIV-associated idiopathic esophageal ulcers", AIDS Res Hum Retroviruses 13:1997:301-304. DL Barnard, JH Huffman, LR Meyerson, RW Sidwell, "Mode of Inhibition of Respirator Syncytial Virus by a Plant Flavonoid, SP-303", Chemother 39:1993:212-217. PA Batman, ARO Miller, SM Forster, JRW Harris, AJ Pinching, GE Griffin, "Jejunal Enteropathy Associated with Human Immunodeficiency Virus Infection: Quantitative Histology", J Clin Pathol 42:1989:275-282. KW Beagley, CO Elson, "Cells and Cytokines in Mucosal Immunity and Inflammation", Gastroenterol Clinics N.A. - Mucosal Immunology II: Clinical Applications 21:1992:347-366. J Bernstein, S Alpert, KM Nause, R Suskind, "Depression of Lymphocyte Transformation following Oral Glucose", abstr. Am J Clin Nutr 30:1977:613. G Caderni, L Lancioni, C Luceri, A Giannini, M Lodovici, A Biggeri, P Dolara, "Dietary sucrose and starch affect dysplastic characteristics in carcinogen-induced aberrant crypt foci in rat colon", Cancer Lett 114:1997:39-41. E DeStefani, ETH Fontham, W Chen, P Correa, H DeneoPellegrini, A Ronco, M Mendilaharsu, "Fatty foods and the risk of lung cancer: A case-control study from Uruguay", Internat J Cancer 71:1997:760-766 (notes association between high sucrose intake and lung cancer). J Duarte, FP Vizcaino, P Utrilla, J Jimenez, J Tamargo, A Zarzuelo, "Vasodilatory Effects of Flavonoids in Rat Aortic Smooth Muscle - Structure-Activity Relationships", Gen Pharmacol 24:1993:857-862. SM Finegold, WL George, editors, Anaerobic Infections in Humans, Academic Press, 1989. J Galvez, A Zarzuelo, ME Crespo, MD Lorente, MA Ocete, J Jimenez, "Anti-diarrhoeic Activity of Euphorbia-hirta Extract and Isolation of an Active Flavonoid Constituent", Planta Medica 59:1993:333-336. MGL Hertog, PCH Hollman, B Vendeputte, "Content of Potentially Anti-carcinogenic Flavonoids of Tea Infusions, Wines, and Fruit Juices", J Agric Food Chem 41:1993:1242-1246. DG Hoover, "Bifidobacteria: Activity and Potential Benefits", Food Technology, June '93, 120-124. SM Hunt, JL Groff, Advanced Nutrition and Human Metabolism, West Publishing Co., 1990. N Ishibashi, S Shimamura, "Bifidobacteria: Research and Development in Japan", Food Technology June '93, 126-136. JM Jacobson, JS Greenspan, J Spritzler, N Ketter, JL Fahey, JB Jackson, L Fox, M Chermoff, AW Wu, LA MacPhail, GJ Vasquez, DA Wohl, "Thalidomide for the treatment of oral aphthous ulcers in patients with human immunodeficiency virus infection", N Engl J Med 336:1997:1487-1493. MAF Jahromi, AB Ray, JPN Chansouria, "Antihyperlipidemic Effect of Flavonoids from Pterocarpus marsupium", J Nat Prod - Lloydia 56:1993:989-994. J Jensen, MBA, MPH, RD, monographs "Modern Food Safety", "Anyone for Another Dozen Pills?", "Diarrhea", "Diarrhea and What you Can do About It", "Mouth Care", "What About Dairy?", "Body Weight Basics", "Your Weight-Gain Program". GE Kaugars, S Silverman, JGL Lovas, RB Brandt, JS Thompson, "A Review of the Use of Antioxidant Supplements in the Treatment of Human Oral Leukoplakia", J Cell Biochem 17F:1993:S292-S298. JD Klausner, S Makonkawkeyoon, P Akarasewi, K Nakata, W Kasinrerk, L Corral, RL Dewar, HC Lane, VH Freedman, G Kaplan, "The effect of thalidomide on the pathogenesis of human immunodeficiency virus type 1 and M-tuberculosis infection", J Acq Immun Defic Synd Hum R 11:1996:247-257. W Kreis, MH Kaplan, J Freeman, DK Sun, PS Sarin, "Inhibition of HIV Replication by Hyssop officinalis Extracts", Antiviral Res 14:1990:323-337. Caffeic acid is identified as an HIV antiviral; a rich source of caffeic acid is sunflower seed. JT La Brooy, "Enteropathy in HIV Infection", J acquir immun defic syndr 6:1993:S16-S19. BQ Li, T Fu, YD Yan, NW Baylor, FW Ruscetti, HF Kung, "Inhibition of HIV Infection by Baicalin - A Flavonoid Compound Purified from Chinese Herbal Medicine", Cell Mol Biol Res 39:1993:119-124. S Makonkawkeyoon, RNR Limsonpobre, AL Moreira, V Schauf, G Kaplan, "Thalidomide Inhibits the Replication of Human Immunodeficiency Virus Type-1", Proc Nat Acad Sci USA 90:1993:5974-5978. I Mucsi, Z Gyulai, I Beladi, "Combined Effects of Flavonoids and Acyclovir Against Herpesviruses in Cell Cultures", Acta Microbiol Hung 39:1992:137-147. MR Nelson, D Erskine, DA Hawkins, BG Gassard, "Treatment with Corticosteroids - a Risk Factor for the Development of Clinical Cytomegalovirus Disease in AIDS", AIDS 7:1993:375-378. M Ott, B Lembcke, H Fischer, R Jäger, H Polat, H Geier, M Rech, S Staszeswki, EB Helm, WF Caspary, "Early Changes of Body Composition in Human Immunodeficiency Virus-infected Patients: Tetrapolar Body Impedance Analysis Indicates Significant Malnutrition", Am J Clin Nutr 57:1993:15-19. DL Paterson, PR Georghiou, AM Allworth, RJ Kemp, "Thalidomide as treatment of refractory aphthous ulceration related to human immunodeficiency virus infection", Clin infect Dis 20:1995:250-254. J-P Raufman, "Odynophagia/Dysphagia in AIDS", Gastroint Manifestations in AIDS, Gastroent Clinics of N.A. 17:1988:599-614. EP Sampaio, G Kaplan, A Miranda, JAC Nery, CP Miguel, SM Viana, EN Sarno, "The Influence of Thalidomide on the Clinical and Immunologic Manifestation of Erythema Nodosum Leprosum", J Infect Dis 168:1993:408-414. A Sanchez, JL Reeser, HS Lau, PY Yahiku, RE Willard, PJ McMillan, SY Cho, AR Magie, UD Register, "Role of sugars in human neutrophilic phagocytosis", Am J Clin Nutr 26:1973:1180-1184. D Schols, P Wutzler, R Klöcking, B Helbig, E de Clercq, "Selective Inhibitory Activity of Polyhydroxycarboxylates Derived from Phenolic Compounds Against Human Immuno-deficiency Virus Replication", J acquir immun defic syndr 4:1991:677-685. These compounds are closely related to caffeic acid for which a good source is sunflower seed. RA Soler, C Migliorati, H vanWaes, D Nadal, "Thalidomide treatment of mucosal ulcerations in HIV infection", Arch Dis Child 74:1996:64-65. PD Smith, UEH Mai, "Immunopathophysiology of Gastrointestinal Disease in HIV Infection", Gastroenterol. Clinics N.A. - Mucosal Immunology II: Clinical Implications 21:1992:331-345. DP Stites, AI Terr, Basic and Clinical Immunology, Appleton & Lange, 1991. C Tournaire, S Croux, MT Maurette, I Beck, M Hocquaux, AM Braun, E Oliveros, "Antioxidant Activity of Flavonoids - Efficiency of Singlet Oxygen (1 g) quenching", J Photochem Photobiol B - Biology, 19:1993:205-215. R Ullrich, M Zeitz, W Heise, M L'age, G Hö ken, EO Riecken, "Small Intestinal Structure and Function in Patients Infected with Human Immunodeficiency Virus (HIV): Evidence for HIV-Induced Enteropathy", Ann Intern Med 111:1989:15-21.
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Decisions about particular medical treatments should always be made in consultation with a qualified medical practitioner who is knowledgeable about HIV-related illness and the treatments in question. MORE | |