I read Dr Wong Ang Peng's letter with great interest. The war against Aids is a global affair. Every avenue has to be explored in mankind's quest for a cure. We currently have good drugs that can effectively suppress HIV replication to the extent that the virus can no longer be detected in the blood. Unfortunately it does come with unwanted side effects. A vaccine for HIV is still far from becoming a reality. Thus, the battle is far from over. So I did a little research in order to substantiate or disprove Dr Wong's.

People infected with HIV are oxidatively stressed. In vitro (ie in laboratories) studies show that HIV replication increases with oxidative stress. So the logic is if we can reduce this oxidative stress, we could supress viral replication. As vitamin C contains anti-oxidants, this could be the answer.

In 1998 at the University of Toronto, researchers did a randomised, placebo-controlled, double-blind study involving 41 HIV positive patients. High doses of vitamin E and Vitamin C (1000mg daily) were given for a period of three months. They then measured the oxidative products and viral load. The patients treated with vitamins E and C showed a decrease in oxidative products as expected.

However there was only a trend in reduction of viral load as compared to the placebo group which was not statistically significant. In simple terms, there is no difference whether you give the vitamins or not in terms of reducing viral load in HIV patients. (Allard JP; Aghdassi E; Chau J; Tam C; Kovacs CM; Salit IE; Walmsley SL Effects of vitamin E and C supplementation on oxidative stress and viral load in HIV-infected subjects.AIDS 1998 Sep 10; 12 (13): 1653-9 Department of Medicine, University of Toronto, Ontario, Canada.)

In another study in 2000 at the University of Oslo, Norway involving 8 HIV positive patients, they looked at the relationship between antioxidants and HIV RNA plasma level and CD4 lymphocyte count. The anti-oxidants were given for 6 days at high doses. The results? There is no significant change in HIV RNA plasma level or CD4 lymphocyte count during the course of anti oxidants. (Muller F; Svardal AM; Nordoy I; Berge RK; Aukrust P; Froland SS Virological and immunological effects of antioxidant treatment in patients with HIV infection. Eur J Clin Invest 2000 Oct; 30 (10): 905-14 University of Oslo, The National Hospital, Rikshospitalet, Oslo, Norway)

At a more molecular level, a team in Japan looked at the effects of vitamin E and C on the inhibition of NF-KappaB-dependant transcription of HIV-1 promoter. They investigated the effects of EPC-K1 which is a phosphodiester compound of vitamin E and C. Although the EPC-K1 did repress the NF-KappaB-dependant transcription of HIV-1 promoter, both vitamin E and C in its natural state did not completely inhibit the activation of HIV-1 promoter.

(Hirano F; Tanaka H; Miura T; Hirano Y; Okamoto K; Makino Y; Makino I Inhibition of NF-kappaB-dependent transcription of human immunodeficiency virus 1 promoter by a phosphodiester compound of vitamin C and vitamin E, EPC-K1. Immunopharmacology 1998 Mar; 39 (1): 31-8 Second Department of Internal Medicine, Asahikawa Medical College, Nishikagura, Japan)

No doubt it is an interesting field that needs further investigation. However, it is not the answer to HIV infection or Aids. It certainly does not cure Aids, and at the most suppresses HIV replication modestly. Current data nevertheless remains vague and inconclusive. A vaccine remains the most feasible answer in order to tackle this global epidemic.