Evidence supporting the use of: N-acetylcysteine
For the health condition: Acquired Immune Deficiency Syndrome

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

N-acetylcysteine (NAC) has been investigated as an adjunctive therapy in Acquired Immune Deficiency Syndrome (AIDS), primarily due to its role as a precursor to glutathione, a critical intracellular antioxidant. During HIV infection and progression to AIDS, glutathione depletion is commonly observed, particularly in lymphocytes, which may contribute to immune dysfunction and increased oxidative stress. Several small clinical studies and in vitro experiments conducted in the 1990s and early 2000s explored whether NAC supplementation could restore glutathione levels, reduce oxidative stress, and improve immune parameters in HIV-infected individuals.

Some trials reported that oral or intravenous NAC increased glutathione levels and appeared to reduce markers of oxidative damage. Additionally, limited data suggested a potential for slower decline in CD4+ T cell counts or delayed disease progression, but results were inconsistent and the studies were generally small, short-term, and sometimes lacked placebo controls. A few studies also investigated symptom improvement, but evidence was inconclusive. Systematic reviews and guidelines do not currently recommend NAC as a standard therapy for HIV/AIDS due to insufficient high-quality evidence for meaningful clinical benefit. Nonetheless, the rationale for its use is based on a mechanistic understanding of oxidative stress in HIV/AIDS and some preliminary clinical results.

In summary, while there is scientific rationale and limited supportive data, the quality and quantity of evidence is modest, and NAC is not a primary or standard treatment for AIDS. Its use in this context remains investigational.

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