None of the clinicians from the mainstream nutrition/dietetics community seems to have recognized the added potential to be gained by use of antimicrobial lipids in the nutritional support treatment of HIV-infected individuals or patients who have progressed to AIDS. These antimicrobial fatty acids and their derivatives are essentially non-toxic to man; they are produced in vivo by humans when they ingest those commonly available foods that contain adequate levels of medium-chain fatty acids such as lauric acid. According to published research, lauric acid is one of the best "inactivating" fatty acids, and its monoglyceride is an even more effective antimicrobial than the fatty acid alone.  [BACK TO TABLE OF CONTENTS]

Recognition of the antimicrobial activity of the monoglyceride of lauric acid (monolaurin) has been reported since 1966. The seminal work can be credited to Jon Kabara at Michigan State University(11). Some of the early work by Kabara that showed virucidal effects of monolaurin on enveloped RNA and DNA viruses was done with selected prototypes or recognized representative strains of enveloped human viruses; the envelope of these viruses is a lipid membrane. This early research was directed at the virucidal effects of monolaurin because there were concerns about viral contamination in foods and monolaurin was seen as having potential related benefits to food preservation.

Kabara and others have reported that certain fatty acids (e.g., medium-chain saturates) and their derivatives (e.g., monoglycerides) can have adverse effects on a variety of microorganisms. Those microorganisms that are inactivated by monolaurin include bacteria, yeast, fungi, and enveloped viruses (Table 1)(5)(11)(13)(19)(20)(21)(22)(23)(24)(25).

The medium-chain saturated fatty acids and their derivatives act by disrupting the lipid membranes of the organisms. In particular, enveloped viruses are inactivated in both human and bovine milk by added fatty acids (FAs) and monoglycerides (MGs) as well as by endogenous FAs and MGs(11). All three monoesters of lauric acid are shown to be active antimicrobials, i.e., -, -, and -MG. Additionally, it is reported that the antimicrobial effects of the FAs and MGs are additive and total concentration is critical for inactivating viruses.

Some of the viruses inactivated by the lauric acid monoglycerides, in addition to HIV, are the measles virus, herpes simplex virus-1 (HSV-1), vesicular stomatitis virus (VSV), visna virus, and cytomegalovirus (CMV). Many of the pathogenic organisms reported to be inactivated by these antimicrobial lipids are those known to be responsible for opportunistic infections in HIV-positive individuals. For example, concurrent infection with cytomegalovirus is recognized as a serious complication for HIV+ individuals. Thus, it would appear to be important to investigate the practical aspects and the potential benefit of an adjunct nutritional support regimen for HIV-infected individuals, which will utilize those dietary fats that are sources of known anti-viral, anti-microbial, and anti-protozoal monoglycerides and fatty acids.

The properties that determine the anti-infective action of these lipids are related to their structure; e.g., monoglycerides, free fatty acids. The monoglycerides are active, diglyceride