African Journal of AIDS and HIV Research

African Journal of AIDS and HIV Research ISSN 2326-2691 Vol. 7 (1), pp. 001-009, January, 2019. © International Scholars Journals

Full Length Research Paper

Single cohort study of the effect of low dose naltrexone on the evolution of immunological, virological and clinical state of HIV+ adults in Mali

Abdel K. TRAORE^1,2, Oumar THIERO^4,7*, Sounkalo DAO³, Fadia F. C. KOUNDE³, Ousmane FAYE¹, Mamadou CISSE⁶, Jaquelyn B. McCANDLESS⁸*, Jack M. ZIMMERMAN⁸, Karim COULIBALY¹, Ayouba DIARRA⁴, Mamadou S. KEITA¹, Souleymane DIALLO³, Ibrahima G. Traore⁴ and Ousmane KOITA^4,5

¹Centre National d’Appui à la lutte contre la Maladie (CNAM), Mali.

²Hôpital National du Point G  (HNPG), Service de Médecine Interne, Mali.

³Hôpital National du Point G (HNPG), Service de Maladies Infectieuses, Service de Pneumo-phtisiologie, Mali.

⁴Laboratoire de Biologie Moléculaire Appliquée (LBMA), Mali.

⁵Faculté des Sciences et Techniques (FAST), Université de Bamako, Mali.

⁶Centre de soins, d’animation et de conseil pour les PVVIH (CESAC), Mali.

⁷Faculty of Medicine, Pharmacy and Otondo- Stomatology (FMPOS), Department of Research in Public Health (DER SP), University of Bamako, Mali.

⁸The Ojai Foundation, California, USA.

Accepted 29 August, 2018

Abstract

To implement an immuno-regulatory approach for reducing or preventing the onset of AIDS symptoms in HIV+ individuals a single prospective cohort study was conducted to evaluate the effect of low-dose naltrexone (LDN) on HIV infected, asymptomatic, otherwise untreated Mali adults with CD4 levels between 350 and 600 cell/mm³. We measured changes in CD4 count, CD4%, BMI, hemoglobin, viral load, interferon alpha, and standard chemistry panel five times over a nine-month period. Linear regression mixed models were used with maximum likelihood as the estimation method for repeated measures on subjects. Of 55 subjects followed, 71% completed the full program without indications of clinical AIDS symptoms, side effects or enough loss of CD4 count to warrant initiation of ART medication. The decrease of CD4 count was marginally significant over the full testing period (p=.066) and became significant as the cohort aged (37.73 cells/mm³ with p=0.027 and 52.94 cells/mm³ with p=0.003, respectively, at six and nine months). In contrast, the estimated mean CD4% did not show significant decrease over the entire study (p=0.842). No other covariates were associated significantly with the results. These findings support the therapeutic potential of LDN in treating HIV+ in its early stages and suggest further studies are indicated.

Key words: HIV, LDN, CD4+, CD4+%, Immuno-regulatory, ART.