Author(s): James JS
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Abstract AIDS: CD4 cells with low levels of glutathione, a biochemical that protects cells from oxidative stress, have been found to be predictive of poor survival. A randomized study of N-acetyl-cysteine, a drug that helps replenish glutathione, began with in-depth analysis of glutathione levels in different lymphocyte subsets, and correlated these levels with survival. Patients with high glutathione levels had a 3-year 60-80 percent survival rate, compared with as low as 20 percent for those with low glutathione. The second part of the study involved randomizing patients to N-acetyl-cysteine or placebo; patients receiving N-acetyl-cysteine had a statistically significant survival advantage over those receiving placebo. Adverse effects thought to be attributed to N-acetyl-cysteine were also observed in the placebo group. There is controversy as to whether further studies of N-acetyl-cysteine should be conducted for several reasons: N-acetyl-cysteine is readily available and is inexpensive, and studies could compromise patients from being able to obtain it on their own; other drug study results could be subject to interference; and there are no validated surrogate markers for continued study of N-acetyl-cysteine. HIV-infected patients are, however, advised to avoid substances, such as acetaminophen and other pain relievers, that inherently lower glutathione levels.
This article was published in AIDS Treat News
and referenced in Journal of Clinical Toxicology