Herbal Medicines for Treating HIV Infection and AIDS

Author

Japing Liu, Evidence-Based Chinese Medicine Centre for Clinical Research and Evaluation, School of Preclinical Medicine, Beijing University of Chinese Medicine, Be I San Human Dong Lu 11,Chaoyang District, 100029,Beijing, China

Proceeding

1st International Conference & Exhibition on Women's Health & Asian Traditional (WHAT) Medicine

Date

23/8/2005

Keyword

complementary therapies, herbal medicine, HIV Infections, AIDS

Abstract

Background: HIV-infected people and AIDS patients often seek complementary therapies including herbal medicines due to the reasons such as unsatisfactory effects, high cost, non-availability, or adverse effects of conventional medicines. Objectives: To assess beneficial effects and risks of herbal medicines in patients with HIV infection and AIDS. Search strategy: Electronic searches included the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, LILACS, Science Citation Index, the Chinese Biomedical Database, TCMLARS; plus CISCOM, AMED, AND NAPRALERT; combined with manual searches. The search ended in December 2004. Selection criteria: Randomised clinical trials on herbal medicines compared with no intervention, placebo, or antiretroviral drugs in patients with HIV infection, HIV-related disease, or AIDS. The outcomes included mortality, HIV disease progression, new AIDS-defining event, CD4 cell counts, viral load, psychological status, quality of life, and adverse effects. Data collection & analysis: Two authors extracted data independently, and assessed the methodological quality of trials according to randomisation, allocation concealment, double blinding, and drop-out. Main results: Nine randomised, placebo-controlled trials, involving 499 individuals with HIV infection and AIDS, met the inclusion criteria. Methodological quality of trials was assessed as adequate in five full publications, and unclear in other trials. Eight different herbal medicines were tested. A compound of Chinese herbs 'IGM-1' showed significantly better effect than placebo in improvement of health-related quality of life in 30 symptomatic HIV-infected patients (WMD 0.66, 95% CI 0.05 to 1.27). IGM-1 appeared not effective in overall health perception, symptom severity, CD4 count, anxiety or depression (Barrack 1996a). Herbal formulation of 35 Chinese herbs was not effective in CD4 cell counts, viral load, AIDS events, symptoms, psychosocial measure, or quality of life (Weber 1999). There was no statistical difference between SPV30 and placebo in new AIDS-defining events, CD4 cell counts, or viral load (Durant 1998) although an earlier pilot trial showed positive effect of SPV30 on CD4 cell count (Durant 1997). Combined treatment of Chinese herbal compound SH and antiretroviral agents showed increased antiviral benefit compared with antiretroviral alone (Sangkitporn 2004). SP-303 appeared to reduce stool weight (p = 0.008) and abnormal stool frequency (p = 0.04) in 51 patients with AIDS and diarrhoea (Holodniy 1999). Qiankunning appeared ineffective in HIV-1 RNA levels (Shi 2003), Curcumin ineffective in viral load or CD4 cell (Hellinger 1996), and Capsaicin ineffective in relieving pain associated with HIV-related peripheral neuropathy (Paice 2000). The occurrence of adverse effects was higher in the 35 Chinese herbs preparation (19/24) than in placebo (11/29) (79% versus 38%, p = 0.003) (Weber 1999). Qiankunning was associated with stomach discomfort and diarrhoea (Shi 2003). Conclusions: There is insufficient evidence to support the use of herbal medicines identified in this review in HIV infected individuals and AIDS patients. Potential beneficial effects need to be confirmed in large, rigorous trials.