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MANY people living with HIV/AIDS also use herbal remedies to treat symptoms of HIV infection or to ameliorate side effects of the antiretroviral drugs and other disease conditions such as malaria, asthma, arthritis, diabetes, and hypertension.
Now, researchers in a study warn that combining antiretroviral drugs (ARVs) with Ocimum gratissium extract is dangerous to health.
In a new study, researchers said the combined use of Ocimum gratissium with ARVs affects the drugs’ effectiveness in reducing the amount of virus in the body of someone living with HIV. Their prolonged use is also toxic to the liver.
Ocimum gratissium is popularly known as scent leaf; it is known as efinrin in Yoruba, nchanwu in Igbo, and daidoya in Hausa. Folklore medicine claims its use in headache, fever, diarrhoea, pneumonia, common colds and infant convulsions.
To test its possible effect, the researchers assessed the concentration of zidovudine, lamivudine and nevirapine (ZLN) in the blood of patients concurrently using antiretroviral drugs (ARVs) and Ocimum gratissium extract.
A well-structured questionnaire was used to interview 60 herbalists from five local government areas (LGA) of Kwara State involved in the management of HIV/AIDS and 300 HIV/AIDS patients attending the highly active antiretroviral therapy (HAART) clinic at the University of Ilorin Teaching Hospital (UITH) to obtain information on types of herbs used in the management of HIV/AIDS.
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Twenty PLWHA attending UITH highly active antiretroviral therapy (HAART) clinic (15 females and 5 males), aged between 35 and 50 years, weighing between 55kg and 70kg were recruited for the study. They were divided into two groups of ten.
Pregnant and nursing mothers and others with medical conditions such as asthma, diabetes, hypertension and drugs such as oral contraceptive pills were exempted from the study. Group A was on a fixed dose of ZLN only, while group B was on ZLN with Ocimum gratissium extract concurrently with 3 teaspoonfuls of Ocimum gratissium preparation twice daily for 28 days.
None of the participants in the study took any other drug for at least two weeks before the commencement of the research and no other drugs were allowed during the study period. Pill counting and daily phone calls were used to monitor subjects’ adherence to the study and subjects were observed taking their drugs and herbs on the final day of the study before blood samples were obtained to determine the ARV levels in the blood of both groups.
A total of 23 plant species from 20 families were identified. Common plant parts used for the concoction were leaves (33.4%), barks (26.7%), roots (16.7%), and seeds (13.3%). Ocimum gratissium had the highest familiarity index of 43%.
All the traditional medicine practitioners utilised at least three different combinations of plants to manage their patients. About 41% of the traditional medicine practitioners made use of four different combinations of plants to treat HIV-infected patients, while 20% of the traditional medicine practitioners used five or more plant combinations to treat their patients. It was in the Centrepoint Journal (Science Edition).
Local herbal mixture, popularly called “agbo iba”, accounted for about 72%, while ”agbo jedi” accounted for 54% of herbs used by the patients. The herbal mixtures usually contain a combination of two or more plants. The plant combinations mentioned by the patients for these herbal mixtures include Ocimum gratissum, bitter leaves and neem leaf. The herbal mixtures are used by the patients to treat malaria and pile.
The study reported that there was a significant decrease in the amount of nevirapine in the blood of those patients that concurrently used ARVs and Ocimum gratissium extract as against those that used ARVs alone, suggesting that individuals on the simultaneous use of these medications may experience ARVs drug treatment failure.
A combined fixed-dose oral antiretroviral drug-containing zidovudine (ZDV), lamivudine (3TC), and nevirapine (NVP) are recommended as the first-line treatment of HIV infection in many developing countries including Nigeria. A decrease in zidovudine concentration may reduce the drug efficacy.
Several studies revealed that PLWHA used traditional medicine to supplement dietary intake of nutrients, boost energy levels, alleviate side effects of antiretroviral therapy (ART), cure opportunistic infections, boost immune response as well as the unverified notion that some traditional medicine can cure HIV/AIDS.
A study at Aminu Kano Teaching Hospital, Kano, found that 4.25% of the 430 patients surveyed also used ARV and traditional medicine concomitantly. Herbal medicines are often used concomitantly with conventional drugs, making potential herb-drug interactions a cause for concern.
Common herbal medicines known to interact with conventional drugs include St. John’s wort, ginkgo, ginger, ginseng and garlic. Herbal medicine and its constituents can modify how the body uses the drug and may eventually lead to toxicity and/or affect the efficacy of conventional drugs.
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