Effect of N-acetylcysteine(NAC) treatment on HIV-1 infection: a double-blind placebo-controlled trial

Eur J Clin Pharmacol. 1996;50(6):457-61. doi: 10.1007/s002280050140.


Objective: In a double-blind placebo-controlled trial, human immunodeficiency virus (HIV)-seropositive patients with a CD4 lymphocyte cell count of more than 200 x 10(6) . l-1 were randomised to receive either 800 mg N-acetylcysteine (NAC) or placebo for 4 months. Before treatment low plasma cysteine levels, high free radical activity in neutrophils in the presence of autologous plasma-measured by the nitroblue tetrazolium (NBT) test- and increased tumor necrosis factor (TNF)-alpha levels were found in the HIV positive patients.

Results: After treatment the low plasma cysteine level in the NAC group increased to normal, and the decline of the CD4+ lymphocyte count before the study start, was less steep in the NAC group than in the placebo group after treatment. There was also a reduction in TNF-alpha level. However, NAC had no effect on the radical production by neutrophils, and although it did not increase the CD4+ cell count, it may have decreased the decline in CD4+ cells.

Conclusion: Further controlled trials with NAC are needed to determine whether it has a beneficial effect in the treatment of asymptomatic HIV-infected individuals.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • Cysteine / blood
  • Double-Blind Method
  • Female
  • Free Radical Scavengers / therapeutic use*
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV-1*
  • Humans
  • Male
  • Middle Aged
  • Neutrophils / metabolism
  • Nitroblue Tetrazolium
  • Superoxides / analysis
  • Tumor Necrosis Factor-alpha / analysis


  • Antiviral Agents
  • Free Radical Scavengers
  • Tumor Necrosis Factor-alpha
  • Superoxides
  • Nitroblue Tetrazolium
  • Cysteine
  • Acetylcysteine