June 30, 2003
Half of U.S. patients infected with HIV use alternative therapies while taking powerful AIDS cocktails, and nearly one in four choose alternative treatments that could interfere with conventional AIDS therapy. And many never share that information with their doctors, researchers have found in a recent study.
Patients often believe that so-called natural treatments are helping to keep them healthy and diminishing the unpleasant side effects of prescription drugs. But megadoses of vitamins, homeopathic remedies and some herbs can reduce the effectiveness of antiretroviral drugs. For example, the herbal antidepressant St. John's wort lowers blood levels of protease inhibitors, including indinavir (Crixivan) and ritonavir (Norvir). As a result, the medication can stop working and HIV can become resistant to antiretrovirals. Garlic can have similar effects on AIDS drugs, warned Dr. Charles Farthing, medical director of the AIDS Healthcare Foundation in Los Angeles.
"The simplest thing is to understand one drug and one herb, but the reality is most people are taking more than that," said Dr. An-Fu Hsiao, lead author of the study. Hsiao's study was sparked by his longtime interest in alternative medicine and his experiences with HIV patients, some of whom were reluctant to discuss their use of alternative therapies because other doctors had "looked down upon them."
While AIDS care providers strongly support alternative therapies like acupuncture, relaxation, massage and hypnotherapy, along with sensible use of multivitamins, they recommend patients avoid herbal remedies or megadoses of vitamins, which can damage the kidneys and other organs. The full study, "Complementary and Alternative Medicine Use and Substitution for Conventional Therapy by HIV-Infected Patients," is published in the June 1 issue of Journal of Acquired Immune Deficiency Syndromes (2003;33(2):157-165).
Los Angeles Times
06.23.03; Jane E. Allen