Effect of N -acetylcysteine(NAC) treatment on HIV-1 infection: a double-blind placebo-controlled trial

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Abstract
Objective: In a double-blind placebo-controlled trial, human immunodeficiency virus (HIV)-seropositive patients with a CD4 lymphocyte cell count of more than 200 × 106⋅l−1 were randomised to receive either 800 mg N-acetylcysteine (NAC) or placebo for 4 months. Before treatment low plasma cysteine levels, high free radical activity in neutrophils in the presence of autologous plasma – measured by the nitroblue tetrazolium (NBT) test – and increased tumor necrosis factor (TNF)-α levels were found in the HIV positive patients. Results: After treatment the low plasma cysteine level in the NAC group increased to normal, and the decline of the CD4+ lymphocyte count before the study start, was less steep in the NAC group than in the placebo group after treatment. There was also a reduction in TNF-α level. However, NAC had no effect on the radical production by neutrophils, and although it did not increase the CD4+ cell count, it may have decreased the decline in CD4+ cells. Conclusion: Further controlled trials with NAC are needed to devermine whether it has a beneficial effect in the treatment of asymptomatic HIV-infected individuals.

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