Background: Supplements are often used to improve the nutritional status of people living with HIV. Arthrospira platensis (Asp) is an alga rich in proteins, minerals, and antioxidants. So far, there has been a paucity of data describing the immune-modulating activity and nutritional properties of Asp. This study describes the influence of Asp supplementation on the immune and nutritional status of HIV patients.Objective: The focus of the study was on a sensitive population of pre-highly active anti-retroviral therapy (HAART) status and gender-oriented towards women. It aimed to assess the effects of a five-gram Asp supplementation on immune regulators and nutritional status.Methods: The nutritional intervention was a pilot randomized placebo-controlled study (RCT) of three months, followed by a three-month open intervention with Asp. The use of a placebo mixture with the same protein calorie potential focused the observed effect on the micronutrient and secondary phytonutrient composition of the microorganism. An additional group of women undergoing a stable antiretroviral therapy was recruited. 73 HAART-naïve and 35 HIV-infected adult women under HAART with CD4 T cell count between 350 and 600 cells/mm3 and a BMI less than or equal 26 were recruited in Yaoundé between June and September 2010. The RCT groups were compared to each other. The six-month intervention groups were discussed separately as well as the Asp intervention on HAART patients. The disease predictors were CD4 cells, viral load, the immune activation marker CD38 expression, and concomitant events. Furthermore, common nutritional markers and the antioxidant marker total antioxidant status on the serum were measured. Statistical analyses were performed with non-parametric tests, and the effect size of each interaction was calculated to assure an adequate analysis of group variance and comparison. Results: There were no significant differences in the immune inflammatory virological markers set during the RCT. In the placebo group, 21 of 30 patients (70%) developed concomitant events, while in the Asp group, only 12 of 28 patients (43%) did. The nutritional markers showed a beneficial aspect for the lipid profile, with a significant decrease in cholesterol of -0.14 (-0.47- -0.04) g/l, p<.004 and a slightly non-significant increase of triglyceride of 0.05 (-0.18- 0.20) g/l. Haemoglobinand erythrocytec ounts were not significantly stimulated by Asp. Serum antioxidant capacities increased by 56 (1- 98) myM and were significantly different from the placebo p<.001 with a large effect size of r=.51. Creatinine showed a significant increase of 0.1 (0.0- 0.2) g/l, p=.002 with a large effect magnitude of r=.59 for the Asp group. The long-term exposure confirmed the tendency of the RCT. The HAART group showed a decrease in cholesterol but no other related effects.Conclusions and Recommendations: The lack of an effect from a supplementation of ten pills per day on immune markers can be considered a lack of therapeutic activity of natural spirulina powder on HIV. However, the intervention seemed to reduce the incidence of concomitant events. The increase in antioxidant capacities could lead to a long-term effect. Furthermore, the decline in cholesterol especially for HAART patients should be the focus of additional research. The enhancing effect of Asp on creatinine should be investigated in a dose-dependent intervention. Moreover, further research on natural local products in terms of nutritional RCT intervention, during early HIV stages, and for patients under HAART on a larger population can be recommend, focusing on both urban and rural settings.
Verknüpfung zu Publikationen oder weiteren Datensätzen
