Human Immunodeficiency Virus (HIV)
Reference: Bouic PJD, Clark A, Brittle W, Lamprecht JH, Freestone M, Liebenberg RW. Plant sterol/sterolin supplement use in a cohort of South African HIV-infected patients-effects on immunological and virological surrogate markers. South African Med J 2001; 91: 848-50.
Study: In an open label pilot study, 123 HIV positive patients (who were not on any retroviral medications) were given a proprietary mixture of sterol/sterolin supplement (Moducare®) on a daily basis over a period of 39 months. Subjects who participated in this study were evaluated at 0, 1, 2, 3 months and then every four months thereafter for body mass, concomitant conditions (e.g. opportunistic infections), CD4 lymphocyte cell count and viral loads. For study purposes, patients were stratified into 3 groups based on CD4 counts at the beginning of the trial: CD4 < 200/µl (n = 10), CD4 200 - 500/µl (n = 66), CD4 > 500/µl (n = 47).
Results: Patients with a CD4 count of less than 200/µl showed a significant reduction in the median percentage and absolute numbers of CD4 cells/µl from baseline values of 11% and 134 CD4/µl to 7% and 23 CD4/µl respectively after 21 months. However, despite this first group's decrease in immunologically active CD4 cells, there was no significant change in the patients' viral load from baseline (4.23 log) to the end of the trial (4.60 log) period. Similarly, patients in Group 2 whose CD4 count was between 200 - 500/µl, showed no significant changes in median CD4 percentage (19% at baseline compared to 18.5% at completion), median CD4 count (349 versus 275/µl) and plasma viral load (5.06 log in contrast to 5.15 log) during the 39 months they were evaluated.
Like the outcomes seen in the other two groups, patients in the third and most immunologically stable group (CD4 > 500/µl) exhibited no changes in their CD4 immune markers. They did however have a significant reduction in plasma viral load of 1.48 log from 4.59 log at the beginning of the study to 3.11 log at 30 months. Moreover, 15% (7/47) of patients within this group had no detectable plasma viral count after 12 months of therapy with plant sterols/sterolins.
Clinical Summary: Although these results should be confirmed in a controlled clinical trial, HIV positive patients whose CD4 count is above 500/µl may be able to stabilize their CD4 cell counts and reduce their viral load through the judicious use of a plant sterol/sterolin mixture (Moducare®) at a dose of 1 capsule 3 times a day between meals.
