Charité Medical Centre Berlin, Germany.
Int J Vitam Nutr Res. 2012 Feb;82(1):63-72. doi: 10.1024/0300-9831/a000095.
In sub-Sahara Africa, micronutrient deficiency, especially of antioxidant micronutrients including vitamins A, C, and E, beta-carotene, selenium, zinc, and polyphenols is very common in HIV-positive patients. Amongst adults, women are the most vulnerable. Antioxidants are known to play a vital role in the immune system, reducing oxidative stress. Oxidative stress is induced by excess production of reactive oxygen species (ROS), due to the HIV infection. Such damage may be prevented or moderated through adequate oral intake of antioxidants, scavenging ROS, as well as protecting cells and tissues against oxidative stress. Antioxidants can be provided to the body through locally available antioxidant rich-diets such as fruit-and-vegetable-based diets and/or dietary supplements. Provision of antioxidants through local diets or dietary supplements exercise beneficial effects on biological markers of the immune system (CD4 and viral load). However, while dietary supplements represent a costly and short-term strategy to limiting antioxidant deficiency, local diets, combined with adequate nutritional education, can provide a low-cost and long-term strategy to reduce oxidative stress, prevent micronutrient deficiency, and slow down HIV disease progression. The former can be applicable in countries around the West, Central, and South coast of Africa, which are rich in natural food resources. In contrast with significant evidence that dietary supplements confer benefits in HIV patients, fewer data are available relating to the benefits of local diets. Thus the need to do more research in this area arises. This review compares available data on effects of antioxidants on CD4 and viral load in HIV-positive women noneligible for antiretroviral therapy. Intake of antioxidants though dietary supplements and local diet, associated with nutritional education, is compared. Studies conducted in sub-Sahara Africa are considered.
在撒哈拉以南非洲,微量营养素缺乏症,尤其是抗氧化微量营养素(包括维生素 A、C 和 E、β-胡萝卜素、硒、锌和多酚)在 HIV 阳性患者中非常普遍。在成年人中,女性最为脆弱。抗氧化剂在免疫系统中起着至关重要的作用,可减少氧化应激。氧化应激是由 HIV 感染引起的活性氧(ROS)过度产生引起的。通过充足的口服抗氧化剂摄入、清除 ROS 以及保护细胞和组织免受氧化应激,可以预防或减轻这种损伤。抗氧化剂可以通过当地富含抗氧化剂的饮食(如水果和蔬菜饮食和/或膳食补充剂)提供给身体。通过当地饮食或膳食补充剂提供抗氧化剂对免疫系统的生物标志物(CD4 和病毒载量)具有有益的影响。然而,虽然膳食补充剂代表了限制抗氧化剂缺乏的昂贵且短期的策略,但当地饮食与充足的营养教育相结合,可以提供一种低成本且长期的策略来减少氧化应激、预防微量营养素缺乏,并减缓 HIV 疾病的进展。这种策略适用于非洲西部、中部和南部沿海地区的国家,这些国家拥有丰富的天然食物资源。尽管有大量证据表明膳食补充剂对 HIV 患者有益,但关于当地饮食益处的数据较少。因此,需要在这方面进行更多的研究。本综述比较了现有关于抗氧化剂对 CD4 和 HIV 阳性、不符合抗逆转录病毒治疗条件的女性病毒载量影响的数据。比较了通过膳食补充剂和当地饮食(与营养教育相关联)摄入抗氧化剂的情况。考虑了在撒哈拉以南非洲进行的研究。
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