N-Acetylcystein has Potential Effect to Reduce Haematological Abnormalities in HIV/AIDS Patients Undergoing ARV Treatment
Aims: to determine the effect of NAC administration on hematological abnormalities in HIV/AIDS patients who are undergoing ARV treatment.
Method: This was a pilot study using a double blind randomized clinical trial. A total of 32 subjects who met the inclusion and exclusion criteria were divided into 2 groups, namely placebo and NAC. Subjects in the NAC group were given NAC at a dose of 3x200 mg/day, while the placebo group was given lactose at a dose of 3x200 mg/day. Each group was given treatment for 12 weeks. Before and after treatment, subjects were examined for hematologic parameters.
Results: Most of subjects had normal hematological features. NAC administration did not have a significant effect on the mean levels of Hb, Ht, number of erythrocytes, leukocytes and platelets (p> 0.05). However, NAC administration can reduce the degree of anemia and improve the condition of thrombocytopenia, leukopenia and lymphopenia.
Conclusion: NAC administration can reduce hematological abnormalities HIV/AIDS patients undergoing ARV treatment.
Keywords: ARV, Hematological abnormalities, HIV/AIDS, NAC.
2. Johannessen A, Naman E, Gundersen SG, Bruun JN "Antiretroviral Treatment Reverses HIV-Associated Anemia in Rural Tanzania" BMC Infect Dis, 2011; 11(190):1–9.
3. Lemarroy CCR, Flores-Cantu H, Calderon-Hernandez HJ, Diaz TMA, Villareal VHJ "Drug-Induced Haemolysis, Renal Failure, Thrombocytopenia and Lactic Acidosis in Patients with HIV and Cryptococcal Meningitis: A Diagnostic Challenge" Int J STD AIDS, 2015; 26(14):1052–54.
4. Emuchay CI, Okeniyi SO, Okeniyi JO "Correlation Between Total Lymphocyte Count, Hemoglobin, Hematocrit and CD4 Count in HIV Patients in Nigeria" Pak J Biol Sci 2014; 17:570–3.
5. Geletaw T, Tadesse MZ, Demisse AG "Hematologic Abnormalities and Associated Factors among HIV Infected Children Pre and Post Antiretroviral Treatment, North West Ethiopia" Journal of Blood Medicine, 2017; 8:99–105.
6. De Jesus E, Herrera G, Teofilo E "Abacavir versus Zidovudine Combined with Lamivudine and Efavirenz, for The Treatment of Antiretroviralnaive HIV-Infected Adults" Clin Infect Dis 2004 39(7):1038–46.
7. Lorna A, Fatoumata D, Fla K, Malatese K, Gueye RD, Aka E, et al "Anemia and Zidovudine-Containing Antiretroviral Therapy in Pediatric Antiretroviral Programs in The Iedea Pediatric West African Database to Evaluate AIDS" J Int AIDS Soc, 2013; 16(1):1–8.
8. Moyle G, Sawyer W, Law M, Amin J, Hill A "Changes in The Efficacy of Thymidine Analog-Based HAART: A Meta-Analysis of Six Prospective, Randomized, Comparative Studies" Clin Ther, 2004; 26(1):92–7.
9. Sharma B. Oxidative Stress in HIV Patients Receiving Antiretroviral Therapy" Current HIV Research, 2014; 12(1):13–21.
10. Bhowmik A, Banarjee P "Hematological Manifestation in HIV Infected Children" Journal of The College of Physiscians and Surgeon, 2015; 25(2):119–23.
11. Katemba C, Muzoora C, Muwanguzi E, Mwambi B, Atuhairwe C, Taremwa IM "Hematological Abnormalities in HIV Antiretroviral Therapy Naive Client as Seen at an Immune Suppression Syndrome Clinic at Mbarara Regional Referral Hospital, Southwestern Uganda" Journal of Blood Medicine, 2018; 9:105–10.
12. Ogbe PJ, Idoko OA, Ezimah AC, Digban KA, Oguntayo BO "Evaluation of Iron Status in Anemia of Chronic Disease Among Patients with HIV Infection" Clinical Laboratory Science, 2012; 25(1):7–12.
13. Ezeonwu BU, Ikefuna AN, Oguonu T, Okafor HU "Prevalence of Hematological Abnormalities and Malnutrition in HIV-Infected Under Five Children in Enugu. Nigerian Journal of Clinical Practice, 2014; 17(3):303–308.
14. Fan HW, Guo FP, Li YJ, Li N, Li TS "Prevalence of Thrombocytopenia among Chinese Adult Antiretroviral Naive HIV Positive Patients" Chinese Medical Journal 2015; 128(4):459–64.
15. Banarjee A, Zhang X, Manda KR, Banks WA, Ercal N "HIV Proteins (Gp120 and Tat) and Methamphetamine in Oxidative Stress Induced Damage in The Brain: Potential Role of The Thiol Antioxidant N-Asetilsisteine Amide" Free Radical Biology & Medicine, 2010; 48(10):1388–98.
16. Ivanov AV, Vladimir TVE, Olga NI, Sergey NK, Elizaveta SS, Birke B, et al "Oxidative Stress During HIV Infection: Mechanisms and Consequences" Oxidative Medicine and Cellular Longevity, 2016; 2016:1–19.
17. Monroy N, Herrero L, Carrasco L, Gonzalez ME "Influence of Glutathione Availability on Cell Damage Induced by Human Immunodeficiency Virus Type 1 Viral Protein R" Virus Research, 2016; 213:116–23.
18. Wagiallah H, Mohammed A "The Effect of Oxidative Stress on Human Red Cells Glutathione Peroxidase, Glutathione Reductase Level, and Prevalence of Anemia among Diabetics" North American Journal of Medical Science, 2011; 3(7):344–7.
19. Basey SBC, Asemota EA, Okoroiwu HU, Etura JE, Efiong EE, Inyang IJ, et al "Glutathione, Glutathione Peroxidase and Some Hepatological Parameters of HIV Seropositive Subjects Attending Clinic in University of Calabar Teaching Hospital, Calabar, Nigeria. BMC Infectious Diseases, 2019; 19(944):1–10.
20. Badley AD, Pilon AA, Landay A, Lynch DH "Mechanisms of HIV Associated Lymphocyte Apoptosis" Blood, 2000; 96(9):2951–64.
21. Scheller C, Jasoy C "Syncytium Formation Amplifies Apoptotic Signals: A New View on Apoptosis in HIV Infection in Vitro" Virology, 2001; 30:48–55.
22. Treitinger A, C Spada, IY Masokawa, JCV Verdi, MVDS. Silveira, MC. Luis, et al "Effect of N-asetilsistein on Lymphocyte Apoptosis, Lymphocyte Viability, TNF-α and IL-8 in HIV Infected Patients Undergoing Anti-Retroviral Treatment" Brazilian Journal of Infectious Disease, 2004; 8(5):363–71.
23. Dobmeyer TS, Stephan F, Jurgen MD, Stefan AK, Bernhard R, Dieter H, et al "Ex Vivo Induction of Apoptosis in Lymphocytes is Mediated by Oxidative Stress: Role for Lymphocyte Loss in HIV Infection" Free Radical & Medicine, 1997; 22(5):775–85.
24. Vijayan KKV, Krithika PK, Srikanth PT, Luke EH "Pathophysiology of CD4+ T Cell Depletion in HIV-1 and HIV-2 Infection" Frontier in Immunology, 2017; 8(580):1–8.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).