compiled by Martin Flynn
News
GREEN TEA ‘CAN PREVENT HIV BINDING TO CD4 CELLS’
Good
news from the University of Sheffield this month where researchers
have found an ingredient in green tea can reduce HIV binding to human CD4
cells by as much as 40 per cent.
Green tea has been drunk in the Far East for millennia for its immune boosting
qualities and has long been advocated as a useful supplement in the arsenal
of complementary therapies for people living with the virus.
But now Sheffield scientists along with colleagues from Baylor College, in
Texas, have found the main flavonoid in green tea, known as epigallocatechin
gallate or EGCC, can reduce HIV replication.
EGCC does this by occupying the CD4 receptor on CD4 cells, thereby preventing
HIV locking onto and docking with the cell.
At low concentrations the effects of green tea were partial, the researchers
found, but just drinking two or three cups of green tea could reduce HIV binding
by as much as ten to 20 times.
But the Sheffield team was quick to say that green tea was no cure for HIV.
“We would not advocate green tea as the sole prophylactic but it may
be useful in combination with other antiretroviral therapies,” said
Dr Mike Williamson, of Sheffield University.
“It is not a cure, and nor is it a safe way to avoid infection. We suggest
it should be used in combination with conventional medicines to improve quality
of life for those infected.
“Future research is under way to determine how much effect can be expected
from different amounts of tea,” he concluded.
• Journal of Allergy & Clinical Immunology 118, 1369-74, 2006.
EXTRA TESTOSTERONE
‘BOOSTS LIBIDO AND WEIGHT GAIN’
People with HIV-related weight loss, muscle wasting and those with
low testosterone levels brought on by long-term use of HIV drugs have for
some time been receiving monthly jabs of testosterone supplements.
And HIV positive men with sexual dysfunction and depression have also been
prescribed testosterone supplements to boost sexual function.
But research from California has found that although people on synthetic testosterone
supplements get a boost to their appetite and put on weight, much of the weight
gained is not lean muscle but fat.
Dr Kathleen Mulligan and colleagues from the University of California studied
79 HIV positive men with low body mass.
After 12 weeks on testosterone the men put on an average of 3kg of lean muscle
but also 2–5kg of fat and those on the additional hormorne supplement
Megestrol acetate reported improved sexual functioning.
But Dr Mulligan cautioned that extra testosterone supplements could suppress
the body’s natural production of the hormone in the long run.
AN EXTRA LITRE OF
WATER A DAY KEEPS YOUR STRESS AWAY
Seventy
per cent of the body is composed of water and people living with
HIV have been advised to drink extra water to improve absorption of drugs
and their liver and kidney function.
Now people living with the virus are being advised to drink even more water
to boost the immune system and to counter dehydration.
Lack of water can aggravate medical conditions such as asthma, allergies,
arthritis, headaches and hypertension, and can even raise cholesterol levels.
For those of us who consume caffeine, alcohol or antiretrovirals, an extra
litre of water each day can improve health and mood. Water literally washes
away tension by flushing out adrenaline and cortisol while boosting feel-good
hormones such as endorphins which make you feel calmer and promote a sense
of well-being.
To check you’re drinking enough water look at the colour of your pee
and the state of the skin on your hands and feet. If your pee is dark in colour
or you have dry skin you need extra water.
But avoid gulping down that extra litre with your meals as this dilutes digestive
juices and prevents absorption of nutrients. Get into the habit of having
a glass of water every couple of hours during the day.
Remember to drink more water in warmer weather and particularly if you are
exercising. A large glass before bed will definitely aid sounder sleep.
Feature LIFE ON THE
RUN Diarrhoea is no
laughing matter and you shouldn’t just put up with it, writes John
Clarkson
Difficult
to spell and harder to live with, diarrhoea will probably affect
everyone living with HIV at some point. It occurs when the water your body
uses to digest food isn’t properly reabsorbed because of inflammation,
infection or damage to the gut lining. This results in stools becoming watery,
more frequent and harder to control.
Verbal diarrhoea
It can be embarrassing to talk bowels with your doctor but they will have
heard it all before, so get over it. And don’t think it isn’t
serious enough to discuss with them; diarrhoea could be a symptom of something
more serious or can lead to dehydration, weight loss and poor absorption of
nutrients and medications.
Get to the bottom of it
Working out why you have diarrhoea can be tricky but these are the main causes:
1 Infection: salmonella, cryptosporidium, giardia, CMV and
MAI often affect us pozzers. Your doctor will want to rule these out and may
ask for a stool sample.
2 Diarrhoea is a side effect of certain HIV meds, especially
protease inhibitors and the nukes (NRTIs) ddI and abacavir. It may stop after
the first weeks of treatment, but for some it becomes a regular part of life.
Diet changes and taking diarrhoea drugs like Imodium 40 minutes before your
HIV meds can help
3 Diet alone is rarely the cause of ongoing diarrhoea, but
changes can alleviate the symptoms – see table below.
4 If a cause cannot be found it will be put down to the effect of HIV
in the gut. Getting CD4 counts up and viral load down with the right combo
should help.
5 Many other bowel disorders can give you the runs; Coeliac
disease (intolerance to foods containing gluten); irritable bowel syndrome
(IBS) could be the cause if accompanied by bloating and pain; Crohn’s
disease is rarer and often accompanied by cramps.
Life on the run
• Diarrhoea can strike out of the blue, so be prepared. Find out where
the toilets are and use the disabled toilets if available. Carry spare underwear,
pads, soothing creams and a plastic bag, just in case. Wearing a pad can help
protect your underwear and make you feel a bit safer.
• If you have night-time attacks put a large pad or towel on your bed
and leave a night light on near your bed, in the hallway and bathroom so that
you can see where you are going and get to the toilet quickly
• Diarrhoea can give you a sore bum, so use baby wipes rather than toilet
paper and haemorrhoid creams to soothe the pain and protect the anus
• In a study, people experiencing diarrhoea associated with the protease
inhibitor nelfinavir (Viracept), were given 500mg of calcium supplements twice
a day. All participants reported dramatic improvements with two thirds reporting
a complete resolution.
• Other things reputed to help include probiotics (see over), peppermint,
ginger and nutmeg.
EAT
• Foods containing soluble fibre help absorb excess
water and bulk the stool: legumes (peas and beans), oats, bananas & peeled
apples, broccoli and peeled carrots, potatoes and onions, psyllim seed husks
from the health food store
• Yoghurt is already partially ‘digested’ by its own bacteria
and may aid digestion (see over)
• Plain foods, such as crackers and dry toast, plain pasta or noodles,
boiled eggs
• Bland foods, such as the BRAT diet (bananas, rice, apple juice, and
toast)
• Clear fluids such as water, herbal teas, non-fizzy drinks, apple and
pear juice
• Keep well hydrated. Water is good but sports drinks like Lucozade
and products like Diaralyte will also replace lost nutrients
• Eat small amounts five to six times throughout the day…
AVOID
• Foods containing insoluble fibre speed food through
the gut, so avoid:
wholegrain foods, nuts and seeds, vegetables such as green beans, courgette,
celery
• Pickled and spicy foods irritate the gut
• Dairy products like milk and cheese tend to make diarrhoea worse but
not in all people
• Fatty fried foods and butter, margarine, oils, or nuts
• Caffeine (and recreational drugs) result in more bowel movements.
Caffeine is found in coffee, cola and tea.
• Alcohol causes diarrhoea by drawing water out of the body and preventing
the gut from absorbing it.
• …rather than three large meals.
Food for thought
PRO- AND PREBIOTICS
Does topping up our friendly bacteria benefit
anyone except Danone and Dr Shirota?
Last
year the UK spent some £200m on probiotic foods, drinks and supplements
containing so-called friendly bacteria. This is despite a mass of contradictory
evidence about whether they do us any good.
What are they?
We often think of bacteria as something to keep away from our bodies with
anti-bacterial washes, wipes and sprays. But, like it or not, they are everywhere;
in the air we breathe, our skin and inside our bodies. Each of us have about
100 trillion bacteria, ten times greater than the number of cells in our bodies.
Some are friendly and help keep us healthy.
Their favourite place is inside the large intestine, because it’s warm
and full of food. About 400 different species make up your ‘gut flora’
and many provide essential services such as aiding digestion; neutralising
toxins and producing nutrients. The biggest claim for probiotics it they prevent
harmful bacteria and fungi from taking over by competing for resources such
as food.
What do they do?
It’s suggested that processed and sweet foods, alcohol, stress and antibiotics
create the right environment for the bad bacteria to overwhelm good bacteria,
leading to poor digestion, diarrhoea and general ill-health. In theory, restoring
the balance restores your health.
Do they work?
It’s hard to know what is going on inside a living being aside from
measuring what goes in and what comes out. A recent study showed small numbers
of bacteria in live yoghurt survive the digestive process making it all the
way through to the large intestine and beyond. Other studies show benefits
in taking probiotics after a course of antibiotics and for people with IBS
or lactose intolerancee. One showed a marked improvement in people with Nelfinavir-related
diarrhoea. But it remains unclear whether they are beneficial in otherwise
healthy people.
Which foods?
There are certain foods ‘friendly bacteria’ love to feast on called
prebiotic foods. They contain substances called oligosaccharides and are essential
to our digestion. These are found in bananas, Jerusalem artichokes, raw oats
and unrefined wheat and barley. A growing body of opinion thinks the best
way to keep the ‘garden in your gut’ in full bloom is by feeding
the existing gut flora a diet high in these foods.
Yoghurt is the main probiotic food. It is made by fermenting milk with certain
strains of bacteria, thickening it and adding the characteristic tang. These
are normally labelled ‘probiotic’ or ‘live’. Some
have further strains of bacteria added specifically for their alleged health
giving properties. Pasteurised yoghurts are not probiotic.
How much?
Probiotic foods and supplements have no recommended daily amount as the evidence
is inconclusive about their effect. However, no one ever died from eating
too much yoghurt, and prebiotic foods are good for you anyway. If you have
diarrhoea or other gut problems they may be worth a try.
Our expert* says
Probiotic research has shown them effective in a variety of bowel-related
conditions, but this depends on the strain and dosage used. To benefit from
them they should contain at least one million to one billion colony-forming
units, the amount normally found in drinks and tablets. Speak to your dietitian
to make sure you’re taking the right one.
If your CD4 count is less than 200 there is a potential risk of blood poisoning.
As this is a developing field I err on the side of caution and advise people
with counts below 200 to avoid probiotics.
*Karen Klassen
is lead HIV dietitian
at St Mary’s Hospital, London
SURVIVAL TIPS
John
Stevens
DX1982: Face your fear
My advice? Face your fear and put your diagnosis into perspective. I was diagnosed
with GRID [HIV’s initial name] in 1982 and HIV in 1985. Though I was
well, I was offered AZT and told it was my only hope.
But, scared as I was, I had read about HIV and AZT and asked for a lower dose.
It still made me sick so I came off it and was fine until 1992 when I had
appalling diarrhoea, losing three-and-a-half stone in three weeks.
Chinese medicine turned it around in two days and I had the best shit ever,
using herbs to keep it solid.
I then read everything I could, questioning the orthodoxy, challenging my
fears, trying to take control of an illness which at that time, few could
control. I tried complementary therapy, worked at the gym, ‘cos muscle
is harder to lose than fat. I started medication in 2000.
A friend was diagnosed recently. He experienced the usual fears everyone does,
regardless of the illness.
After a while I told him he had to move on, to face his illness, learn about
HIV, and put his health and future in context. There are far worse illnesses
to have. People with HIV around the world don’t enjoy the luxury of
our health care. I told him of the courage of the people who died in the early
years and how he should learn about their struggles, what they faced, then
ask himself is he luckier than they? He followed my advice and today he has
returned to a normal life.
If people understood the history of HIV, how people used to suffer appalling
and painful deaths, if they realised in most of the world HIV is a death sentence,
perhaps they may realise how lucky we are. There’s a lot for us to feel
lucky about. I feel lucky.
