Herpetic Infections

One study has shown the topical treatment of recurrent herpes labialis with an ascorbic acidcontaining preparation resulted in statistically significant reduction in clinical signs and symptoms. 100 In another study, the efficacy of a systemic water-soluble bioflavonoid-ascorbic acid complex was evaluated in the treatment of fifty episodes of recurrent herpes labialis.101 Twenty episodes were treated with a complex of 600 mg of water-soluble bioflavonoids and 600 mg of ascorbic acid, administered in equal increments three times daily. Twenty episodes were treated with a complex of 1,000 mg of water-soluble bioflavonoids and 1,000 mg of ascorbic acid, administered in equal increments five times daily. Ten episodes were treated with a lactose placebo. The therapeutic regimens were maintained for 3 days after the recognition of the initial symptoms associated with recurrent herpes labialis. The water-soluble bioflavonoid-ascorbic acid complex was observed to reduce vesiculation and to prevent the disruption of the vesicular membrane. The therapeutic measure was found to be the most effective when initiated during the prodromal stage of the disease process. No significant difference in the remission of symptoms was observed between the 600 mg and the 1,000 mg regimens, but both were statistically superior to the placebo (p<0.01).

Bioflavonoids maintain normal capillary permeability; ascorbic acid is known to maintain the normal mechanical strength of capillaries, to promote collagen formation, and to facilitate wound healing. Susceptible patients may benefit from the prophylactic intake of a bioflavonoid-ascorbic acid complex if initiated 24 hours prior to exposure to factors known to precipitate herpes labialis.

HIV infection

A fundamental immunologic abnormality in HIV infection is the progressive decrease and functional impairment of CD4+ lymphocytes. The functional capacity of lymphocytes is critically dependent on intracellular redox balance and oxidative stress.

An inability of antioxidants to neutralize the formation of reactive oxygen species has been shown to impair lymphocyte functions.102,103 Glutathion, a cysteine-containing tripeptide, is the dominant intracellular antioxidant.104 Several reports have suggested decreased antioxidant defense due to disturbed glutathione homeostasis plays a role in the immunopathogenesis of HIV infection.105,106,107

Antioxidants such as N-acetyl cysteine, glutathione, glutathione-esters, and vitamin C have been demonstrated to inhibit HIV replication in vitro and several of these antioxidants appear to have cooperative interactions.108-111 In vivo, vitamin C and E have been shown to reduce oxidative stress in HIV infected patients and to reduce the viral load.112