Reactive oxygen species, antioxidants, and acquired immunodeficiency syndrome: sense or speculation?

Article Abstract:

AIDS is caused by infection with the human immunodeficiency virus (HIV), and it appears likely that most or all of those who have been infected with the virus will go on to develop AIDS. Zidovudine (AZT) is the only drug approved for the treatment of AIDS, but it produces toxic side effects. Recently, reports have indicated that reactive oxygen species (free radicals) may play a role in the development of HIV infection and in some of the side effects of zidovudine. A free radical (for example, hydrogen peroxide) contains an unpaired electron, and can react with other substances. Free radicals, when produced in excess, have been implicated in a number of human diseases. If HIV infection causes oxidative stress, as lowered concentrations of thiol indicate, treatment with an antioxidant would be logical. Zidovudine reportedly raised glutathione levels, and in other research, thiol compounds aided cells from infected patients to form T-cells (cells that regulate immune responses) in vitro (in the test tube). The antioxidant properties of other thiol compounds are also being explored. Based on the scattered evidence of antioxidant deficiency in patients infected with HIV, there are numerous proposals for antioxidant therapy such as treatments using vitamin E, vitamin C (ascorbic acid), and others. The authors state that the evidence does not yet justify the testing of antioxidant therapies. Lowered levels of glutathione may be caused by circadian (24-hour) variation, depressed appetite, malabsorption, or a number of other factors. High doses of vitamin E depress antibacterial activity, possibly promoting infection. Vitamin C, even if it does not help, will not hurt. However, one should remember that low levels of free radicals may be beneficial, and excessive use of antioxidants could cause harm. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, HIV infection, Drug therapy, HIV infections, Antioxidants, Antioxidants (Nutrients), Zidovudine, Free radicals (Chemistry), Free radicals, Glutathione, editorial

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Patients' fear of contracting the acquired immunodeficiency syndrome from physicians

Article Abstract:

Health providers can be infected with the human immunodeficiency virus (HIV) as a result of direct or accidental exposure. Studies show that physicians and health providers are concerned about contracting the acquired immunodeficiency syndrome (AIDS) from patients. However, there are few studies examining patients' fears of exposure to HIV in the health care setting. A telephone survey of 2,000 Americans showed that 56 percent of persons questioned would change physicians if they learned that their physician was infected with HIV. Twenty-five percent of persons surveyed indicated that they would change physicians if they found that their physician was treating patients with AIDS. Although there have been no reports of a physician transmitting HIV to a patient, transmission of AIDS from health providers to patients remains an area of concern. The concern of patients about acquiring infection with the human immunodeficiency virus (HIV) from their physician during routine medical care was evaluated. Specifically, 350 patients were questioned about their fear of acquired immunodeficiency syndrome (AIDS); knowledge about HIV transmission; level of comfort with medical procedures performed by a physician suspected of having AIDS; perceived risk of HIV transmission in physician-patient interactions; and desire to be informed of the HIV status of physicians. The results showed that as the fear of AIDS increases, the level of discomfort with procedures performed by a physician suspected of having AIDS also increases. The fear of AIDS was associated with a limited knowledge of the disease. It is recommended that more education about the transmission of AIDS should be provided to patients to allay their fears of acquiring HIV infection from their physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Health aspects, Physician and patient, Physician-patient relations, HIV (Viruses), HIV, Disease transmission, AIDS (Disease)

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