Use of Chinese medicine in HIV patients

This survey of male Chinese HIV patients provides an opportunity to review the risk for interactions between Chinese herbal medicine and drugs used to treat human immunodeficiency virus (HIV).

First, the details.

• 76 men with HIV answered questions about their use of traditional Chinese medicine (TCM).

And, the results.

• A variety of herbal tea and other health products of TCM were reported.
• No specific TCM recipe was preferentially used.
• 29% had consulted a TCM practitioner in the preceding 6 months.
• 60% used TCM to treat minor ailments.
• 58% used TCM for general health maintenance.
• More than 75% of TCM users did not consult any clinic staff on their use of TCM.
• Many used TCM at a different time from HAART in order to not affect HAART’s effectiveness.

The bottom line?
The results show that most Chinese men with HIV use TCM.

And regardless of why they take them, these patients are not predisposed to tell their allopathic heatlhcare professionals about it, and the risk of drug integrations with HAART exist in these pateints

The Body website, maintains a long list of herbals used by people living with HIV. Here are the herbals that have a role TCM and would be of interest to doctors and other healthcare professionals who treat Chinese-American patients with HIV.

Andrographis paniculata

• A weed found primarily in India, Thailand, and Indonesia.
• A drug called AndroVir, which is made from Andrographis paniculata, increases in CD4+ counts, but less than HAART.
• The dried plant is also known as chuan-xin-lian, chuan-hsin-lien, and i-and chien-hsi.

Astragalus (Astragalus membranaceus)

• A bone marrow stimulant.
• One of the first herbs identified as a potentially useful treatment for HIV.
• No study in HIV, but there’s evidence of its immune stimulatory effect.
• May cause gas, bloating, low blood pressure, and increased frequency of urination, but side effects are rare when it’s taken in moderate doses.
• Caution if used with anticoagulant drugs (warfarin [Coumadin]).

Atractylodes macrocephala

• Baizhu is the Chinese name for the root of this plant.
• Some evidence for increased cell-mediated immunity.
• HIV-positive people use Atractylodes to help increase body weight and muscle strength, reduce diarrhea, and enhance immune function.
• May reduce platelet function, so use cautiously if platelet counts are low or if there’s bleeding.

Ginger (Zingiber officinale)

• People with HIV may use it to treat nausea associated with drug treatments.
• Caution in people with low platelet counts.
• Dried ginger can elevate blood pressure in those with hypertension.

Ginkgo biloba

• Used to treat depression and impotence.
• Also used to treat memory loss.
• Caution in people with low platelet counts and bleeding disorders.

Ginseng

• Used to increase stamina and to stimulate mental alertness.
• Panax ginseng might also stimulate production and function of immune cells, although high doses might suppress the immune system.
• High doses or long-term use of Siberian and P. ginseng may elevate blood pressure and cause anxiety and insomnia.
• Some people report insomnia even when taking lower doses.
• Drug interactions have been reported with acetylsalicylic acid (aspirin) and corticosteroids.
• People taking ginseng may need to take vitamins B1, B2 and C.

Goldenseal (berberine; Hydrastis canadensis)

• Often combined with echinacea.
• High doses may suppress the immune system and cause nausea, vomiting, and tingling in the hands and feet (neuropathy).
• May interfere with the metabolism of B vitamins.
• Long-term use of berberine may adversely affect the bowel function.

Greater celandine (Chelidonium majus)

• Used to treat indigestion.
• Has been used to treat Kaposi’s sarcoma (the most common cancer in people with HIV).
• May have beneficial immune modulating effects in people with HIV.
• Overdoses, may cause nausea, vomiting, and bloody diarrhea.
• Skin contact with the fresh herb may result in a rash.

Isatis (Isatis tinctoria)

• Used to treat infection.
• Has antiviral properties.
• Recommended for short-term therapy.

Mushrooms: Reishi, shiitake and maitake

• Studies of shiitake are here.
• Can cause stomach upset or diarrhea, particularly if taken on an empty stomach.
• Severe allergic reactions are possible.

Tricosanthin

• Derived from the root of the Chinese herb Trichosanthes kirilowii or guo lou.
• Also known as Compound Q — not be confused with Co-enzyme Q10,
• Was not effective to treat HIV in 1 study.
• Muscle and joint pain, raised liver enzymes and flu-like symptoms have been reported.
• Also, neurological problems, including disorientation, hallucinations, and coma, have been reported.

Go to The Body for more information.

11/26/08 22:17 JR