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HIV / AIDS and DHEA
DHEA levels tend to be low in individuals infected with the human
immunodeficiency virus (HIV), and these levels decline even further as the
disease progresses.
Some people with HIV take DHEA
in amounts designed to restore normal levels. This might help improve their
energy levels.
HIV-positive men with lower
DHEA levels have comparably lower CD4 cell counts and are 2.3 times more
likely to progress to AIDS. HIV-positive men have a dramatically elevated
cortisol/DHEA ratio that parallels their nutritional and disease status.
Clinical Studies
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Several studies have found that DHEA increases
levels of
IL-2, a
chemical messenger that increases the production of
CD4 (T-helper)
cells. DHEA also improves the ability of CD8 (T-killer) cells to destroy
infected cells. DHEA may help normalize the immune system.
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A recent study shows that DHEA can reduce
depression in people with HIV.
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In one small clinical study, DHEA
supplementation improved mental function in men and women infected with
HIV. However, studies in humans have yet to demonstrate whether DHEA
supplementation can improve immune function in people with this condition.
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New York State Psychiatric Institute, NY 10032,
USA.
The goal of this pilot study was to evaluate the effect of
dehydroepiandrosterone (DHEA) on depressed mood and fatigue in HIV+ men
and women, unselected for baseline DHEA level. Secondary questions
concerned treatment effects on libido and body cell mass, on serum
testosterone levels, and elicitation of short-term side effects. Treatment
consisted of an open-label 8-week trial using DHEA doses from 200 to 500
mg/day. Mood responders were maintained for another 4 weeks, then
randomized to a double blind placebo controlled 4-week discontinuation
trial. Forty-five patients, including six women, entered the trial. Of 32
week 8 completers, mood was much improved in 72%, and 81% were rated
responders with respect to fatigue. Response on either parameter was
unrelated to baseline serum DHEA level. Twenty-one patients entered the
double blind discontinuation phase. No differences in relapse rate between
placebo and DHEA groups were observed for either mood or fatigue. Body
cell mass increased significantly by week 8, and this improvement was
maintained throughout the double blind phase for patients in both
treatment conditions. Libido increased significantly as well. DHEA therapy
did not have an effect on CD4 cell count or on serum testosterone levels
in men. In conclusion, DHEA may be a promising treatment for HIV+ patients
with depressed mood and fatigue, although persistence of response even in
placebo-treated patients during the discontinuation phase leaves
unresolved questions.
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