***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We wished to determine the short-term safety and efficacy of a Chinese medicinal herb preparation in treating symptoms of human immunodeficiency virus ( HIV ) infection in a 12-week r and omized , double-blind , placebo-controlled clinical trial in a University-affiliated acquired immunodeficiency syndrome ( AIDS ) clinic at a public general hospital . Thirty adults with symptomatic HIV infection , no previous AIDS-defining diagnosis , and CD4 + counts of 0.200 - 0.499 x 10(9)/L ( 200 - 499/mm3 ) received 28 tablets each day of either a st and ardized oral preparation of 31 Chinese herbs or a cellulose placebo . Primary outcome measures were changes in life satisfaction , perceived health , and number and severity of symptoms . Other outcomes included adherence , and changes in weight , CD4 + count , depression , anxiety , physical and social function , and mental health . Two placebo- and no herb-treated subjects had mild adverse events ( AE ) . Subjects on both arms reported taking 94 % of prescribed tablets . No differences between treatment groups reached the p < 0.05 level . Life satisfaction improved in herb-treated [ + 0.86 , 95 % confidence interval ( CI ) : + 0.29 , + 1.43 ] but not in placebo-treated subjects ( + 0.20 , 95 % CI -0.35 , + 0.75 ) . Number of symptoms was reduced in subjects receiving herbs ( -2.2 , 95 % CI -4.1 , -0.3 ) but not in those receiving placebo ( -0.3 , 95 % CI -3.2 , + 2.7 ) . There were trends toward greater improvements among herb-treated subjects on all symptom subscales except dermatologic . Believing that one was receiving herbs was strongly associated with reporting that the treatment had helped ( p < 0.005 ) , but not with changes in life satisfaction or symptoms . There were improvements in life satisfaction and symptoms among subjects receiving the herbal therapy . Whether Chinese herbs are effective in the management of symptomatic HIV infection can be adequately addressed only by larger trials of longer duration Assigned r and omly 28 neonates born to HIV-positive mothers to a massage therapy  or control group . The treatment infants were given three 15-minute massages daily for 10 days . The massaged group showed superior performance on almost every Brazelton newborn cluster score and had a greater daily weight gain at the end of the treatment period unlike the control group who showed declining performance CONTEXT Peripheral neuropathy is common in persons infected with the human immunodeficiency virus ( HIV ) but few data on symptomatic treatment are available . OBJECTIVE To evaluate the efficacy of a st and ardized acupuncture regimen ( SAR ) and amitriptyline hydrochloride for the relief of pain due to HIV-related peripheral neuropathy in HIV-infected patients . DESIGN R and omized , placebo-controlled , multicenter clinical trial . Each site enrolled patients into 1 of the following 3 options : ( 1 ) a modified double-blind 2 x 2 factorial design of SAR , amitriptyline , or the combination compared with placebo , ( 2 ) a modified double-blind design of an SAR vs control points , or ( 3 ) a double-blind design of amitriptyline vs placebo . SETTING Terry Beirn Community Programs for Clinical Research on AIDS ( HIV primary care providers ) in 10 US cities . PATIENTS Patients with HIV-associated , symptomatic , lower-extremity peripheral neuropathy . Of 250 patients enrolled , 239 were in the acupuncture comparison ( 125 in the factorial option and 114 in the SAR option vs control points option ) , and 136 patients were in the amitriptyline comparison ( 125 in the factorial option and 11 in amitriptyline option vs placebo option ) . INTERVENTIONS St and ardized acupuncture regimen vs control points , amitriptyline ( 75 mg/d ) vs placebo , or both for 14 weeks . MAIN OUTCOME MEASURE Changes in mean pain scores at 6 and 14 weeks , using a pain scale ranging from 0.0 ( no pain ) to 1.75 ( extremely intense ) , recorded daily . RESULTS Patients in all 4 groups showed reduction in mean pain scores at 6 and 14 weeks compared with baseline values . For both the acupuncture and amitriptyline comparisons , changes in pain score were not significantly different between the 2 groups . At 6 weeks , the estimated difference in pain reduction for patients in the SAR group compared with those in the control points group ( a negative value indicates a greater reduction for the " active " treatment ) was 0.01 ( 95 % confidence interval [ CI ] , -0.11 to 0.12 ; P=.88 ) and for patients in the amitriptyline group vs those in the placebo group was -0.07 ( 95 % CI , -0.22 to 0.08 ; P=.38 ) . At 14 weeks , the difference for those in the SAR group compared with those in the control points group was -0.08 ( 95 % CI , -0.21 to 0.06 ; P=.26 ) and for amitriptyline compared with placebo was 0.00 ( 95 % CI , -0.18 to 0.19 ; P=.99 ) . CONCLUSIONS In this study , neither acupuncture nor amitriptyline was more effective than placebo in relieving pain caused by HIV-related peripheral neuropathy A pretest-posttest design ( with a 6-week wait-list control and a 6-month comparison group ) was used to compare the effectiveness of a 6-week stress management training program with st and ard outpatient care for 45 men with HIV disease . Outcomes included stress levels , coping patterns , quality of life , psychological distress , illness-related uncertainty , and CD4 + T-lymphocyte levels . At 6 weeks , intervention was associated with increases in the emotional well-being dimension of quality of life . After 6 months , the intervention group had a relative decline in HIV-related intrusive thinking , indicating that stress management training may have buffered illness-related psychological distress over time The objective of the present study was to compare the efficacy and safety of two doses of SPV(30 ) in HIV asymptomatic patients . The study was design ed as a r and omized double-blind multicentre trial of two doses of SPV(30 ) ( 990 mg/d and 1980 mg/d ) versus placebo .  145 previously untreated subjects with asymptomatic HIV infection ( CDC group IV ) and CD4 cell counts between 250 and 500 × 10(6)/1 were recruited . There was a statistically significant difference in therapeutic failures between groups in favor of SPV(30 ) 990 mg including decreases of CD4 cell count < 200 × 10(6)/1 and /or number of clinical aggravations ( progression to AIDS or AIDS related complex ) . The treatment groups differed statistically in the rate of disease progression also in favor of SPV(30 ) 990 mg/d . Fewer patients receiving SPV(30 ) 990 mg/d had at the end an increase of viral load greater than 0.5 log ( P = 0.029 ) . No severe side-effects were reported in the 3 groups . From these results we conclude that SPV(30 ) 990 mg/d has beneficial effects in HIV asymptomatic patients and appears to delay the progression of HIV disease This study tested the effects of a 10-week group cognitive-behavioral stress management ( CBSM ) intervention on mood and immunologic parameters in HIV-seropositive gay men whose disease had progressed to a symptomatic stage . Men were r and omized to either CBSM or a modified waiting-list control group . The CBSM intervention significantly decreased self-reported dysphoria , anxiety , and total distress . Individuals who practice d relaxation more consistently had significantly greater drops in dysphoria . The intervention also decreased herpes simplex virus-Type 2 ( HSV-2 ) immunoglobulin G antibody titers . The control group showed no significant changes in either mood or antibody titers . Individual difference analyses revealed that decreases in dysphoria significantly predicted lower HSV-2 antibody titers by the end of the 10-week period . Neither group displayed changes in HSV-Type 1 antibody titers or in CD4 + or CD8 + cell numbers We tested the impact of stress management training on sexual behavior and immune functioning in 64 gay men infected with human immunodeficiency virus ( HIV ) . Subjects r and omized to the stress management group met for eight two-hour sessions and one all day retreat to learn systematic relaxation , health behavior change , and stress management skills . Compared to those r and omized to a wait list control , treatment subjects reported significantly fewer sexual partners in the prior month at post-test ( 1.10 vs 2.29 for controls ) . There were no differences between groups in lymphocyte numbers and function Objective Reduced levels of serum carnitines ( 3-hydroxy-4-N-trimethyl-ammonio-butanoate ) are found in most patients treated with zidovudine .  However , since serum carnitines do not strictly reflect cellular concentrations we examined whether a carnitine depletion could be found in peripheral blood mononuclear cells ( P BMC ) from AIDS patients with normal serum carnitine levels . In addition , we explored whether it was posssible to relate the host 's immunoreactivity to the content of carnitine in P BMC and whether carnitine levels can be corrected by oral supplementation of L-carnitine . Design Immunopharmacologic study . Methods Twenty male patients with advanced AIDS ( Centers for Disease Control and Prevention stage IVCI ) and normal serum levels of carnitines were enrolled . Patients were r and omly assigned to receive either L-carnitine ( 6g/day ) or placebo for 2 weeks . At baseline and at the end of the trial , we measured carnitines in both sera and P BMC , serum triglycerides , CD4 cell counts , and the frequency of cells entering the S and G2-M phases of cell cycle following mitogen stimulation . Results Concentrations of total carnitine in P BMC from AIDS patients was lower than in healthy controls . A significant trend towards the restoration of appropriate intracellular carnitine levels was found in patients treated with high-dose L-carnitine and was associated with an increased frequency of S and G2-M cells following mitogen stimulation . Furthermore , at the end of the trial we found a strong reduction in serum triglycerides in the L-carnitine group compared with baseline levels . Conclusions Our data indicate that carnitine deficiency occurs in P BMC from patients with advanced AIDS , despite normal serum concentrations . The increase in cellular carnitine content strongly improved lymphocyte proliferative responsiveness to mitogens . Because carnitine status is an important contributing factor to immune function in patients with advanced AIDS , we therefore believe that L-carnitine supplementation could have a role as a complementary therapy for HIV-infected individuals The use of vitamin A therapy during human immunodeficiency virus ( HIV ) infection is under clinical investigation , and vitamin A could potentially modulate HIV replication because the virus genome contains a retinoic acid response element . A r and omized , double-masked , placebo-controlled clinical trial was conducted to determine the impact of single high-dose vitamin A supplementation , 60-mg retinol equivalent ( 200,000 IU ) , on HIV load and CD4 lymphocyte count .  HIV-infected injection drug users ( 120 ) were r and omly allocated to receive vitamin A or placebo .  Plasma vitamin A level , CD4 lymphocyte count , and HIV load were measured at baseline and 2 and 4 weeks after treatment . Vitamin A supplementation had no significant impact on HIV load or CD4 lymphocyte count at 2 and 4 weeks after treatment . This study suggests that high-dose vitamin A supplementation does not influence HIV load Objectives : The HIV-infected population is known to be oxidatively stressed and deficient in antioxidant micronutrients . Since in vitro replication of HIV is increased with oxidative stress , this study assessed the effect of antioxidant vitamin supplementation on lipid peroxidation , a measure of oxidative stress , and viral load in humans . Design : A r and omized placebo-controlled , double-blind study . Methods : Forty-nine HIV-positive patients were r and omized to receive supplements of both DL-α-tocopherol acetate ( 800 IU daily ) and vitamin C ( 1000 mg daily ) , or matched placebo , for 3 months . Plasma antioxidant micronutrient status , breath pentane output , plasma lipid peroxides , malondialdehyde and viral load were measured at baseline and at 3 months . New or recurrent infections for the 6-month period after study entry were also recorded . Results : The vitamin group ( n = 26 ) had an increase in plasma concentrations of α-tocopherol ( P < 0.0005 ) and vitamin C ( P < 0.005 ) and a reduction in lipid peroxidation measured by breath pentane ( P < 0.025 ) , plasma lipid peroxides ( P < 0.01 ) and malondialdehyde ( P < 0.0005 ) when compared with controls ( 
    Output:
    
While the former category yields few encouraging results , the latter group of studies is more promising .
In particular , stress management may prove to be an effective way to increase the quality of life .
The domain of complementary medicine may lie in the care for HIV-infected individuals with a view of increasing their quality of life .