HIV Infection And Botanical Therapies

An estimated 19.2 million women worldwide are living with HIV infection or AIDS. Since the early 1990s, the proportion of AIDS cases in females aged 13 to 49 years has tripled from 7% to 25%. Appropriate treatment is essential to the wellness and longevity of HIV / AIDS patients. Conventional medical treatment, for example, highly active antiretroviral therapy (HAART), which consists of a combination of antiretroviral therapies, including protease and reverse transcriptase inhibitors, is showing tremendous promise. Numerous HIV patients also use complementary and alternative therapies such as herbs and nutritional supplements in conjunction with their medical treatment, or in some cases, in lieu of conventional therapies. This chapter looks at the statistics and demographics of complementary and alternative medicine use for HIV / AIDS, reasons for use, risks and benefits associated with use, and provides a brief review of the literature based on two major reviews conducted by other researchers. There is a tremendous paucity of evidence on botanical therapies for HIV / AIDS; however, there is also a tremendous amount of human experience in the HIV community regarding natural therapies that may support conventional treatment, and also may eventually point the way to more effective integrative therapies.

A comprehensive overview of HIV / AIDS is beyond what can be adequately covered within the scope of this site. The author hopes that this post will provide a glimmer of insight into the nature of complementary and alternative medicine use by individuals with HIV / AIDS and elucidate the need for both practitioner understanding of patient motivation for using complementary and alternative medicine therapies with HIV / AIDS, and the tremendous need for further research in this area.

Complementary And Alternative Medicine Use In The HIV / AIDS Population

Why Are HIV / AIDS Patients Turning To Complementary And Alternative Medicine Therapies?

Benefits Of Complementary And Alternative Medicine Therapy

Perhaps most significantly, patients have reported that the use of complementary and alternative medicine therapies enables them to remain on conventional treatment protocol, which is often accompanied by minor to debilitating side effects including fatigue, nausea, diarrhea, vomiting, anemia, neuropathy, and pancreatitis. Foote-Ardah found that patients were using acupuncture for relief of neuropathic pain, Chinese herbs for nausea, and marijuana to improve appetite and weight gain. The psychoemotional well-being and sense of empowerment reported by individuals using complementary and alternative medicine therapies for the treatment of HIV / AIDS, as well as the increased ability of patients to comply with pharmaceutical regimens as a result of using herbs, etc, represents an important benefit, as long as the complementary and alternative medicine therapies do not interfere with the medication or are not themselves harmful. This in itself should be a central reason for conventional practitioners to support their patient’s choice to use complementary and alternative medicine therapies with no demonstrated harm, and should encourage research on the safety and efficacy of botanicals used as adjunct therapies for associated complaints of HIV / AIDS patients and for side effects of HIV / AIDS pharmacotherapy, as well as herb-drug interactions. Clearly a combination of the two models is desired by the majority of HIV patients and may represent a simple, safe, and empowering method of treating minor to major complaints and side effects while lending a sense of empowerment to those who may otherwise at times feel entirely dependent on medical care and with very few medical options.

Risks Of Complementary And Alternative Medicine Use In HIV / AIDS

The major risks of using botanicals for HIV / AIDS and AIDS-related conditions are inherent risks of using unsafe therapies, foregoing use of conventional treatment in favor of therapies that may be ineffective, delaying necessary medical therapies for too long, and interactions that may interfere with the efficacy or safety of conventional therapies. Further, unnecessary cost to the patient may be considered an associated risk. For some, the use of complementary and alternative medicine to forestall beginning conventional therapy, in conjunction with evaluation of CD4 counts, has allowed them to maintain a sense of autonomy from medical dependence for as long as possible, and has been met with positive outcomes. Including delayed disease progression. Other patients, however, have not fared as well, with attempts to avert medication with complementary and alternative medicine therapies leading to the development of serious opportunistic infections. Unfortunately, very little is known about the safety and efficacy of combining herbs and conventional HIV / AIDS pharmaceutical therapies, both directly for the reduction of viral load or enhancement of immunity, or for the treatment of side effects of medications or conditions associated with HIV / AIDS, such as fatigue, other infections, and depression.

Efficacy Of Botanical Therapies In HIV / AIDS

Safety Issues With Herbs And HIV / AIDS Therapy

There is no comprehensive list of herbs to be avoided by HIV / AIDS patients. The efficacy and safety of standard HIV / AIDS pharmacotherapy is dependent upon many delicate and complex mechanisms (e.g., cytochrome P450 metabolism), which may be affected by any number of substances, including botanical medicines. Several herbs are known to significantly interfere with the CYP450 system, most notably St. John’s wort, which is contraindicated with HIV / AIDS pharmacotherapy. Although there is only very low-level evidence that herbal products might interfere with protease inhibitors, garlic and St. John’s wort may reduce HIV drug concentrations and lead to drug failure. Caution and knowledge of potential interactions are needed when combining HIV / AIDS therapies and herbal medicines. Cooperation between conventional and complementary and alternative medicine practitioners in the treatment of HIV / AIDS patients may help to increase the efficacy and sustainability of treatment protocol for patients while minimizing unwanted effects.

Overview Of Immunomodulating Herbs Commonly Used In HIV / AIDS