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By Caroline Hooper-Box
The special mixture prescribed by Manto Tshabalala-Msimang, the minister of health, for fighting HIV and Aids looks as though it could be a recipe for disaster.
A new study published this month by Aids, one of the world's leading HIV journals, said that the African potato (Hypoxis hemerocallidea) might significantly weaken the power of anti-HIV medicines (antiretrovirals or ARVs) by altering their concentration in the bloodstream.
The African potato is just part of the concoction of garlic, onions and virgin olive oil Tshabalala-Msimang has repeatedly advocated as an immune-boosting combination for people living with HIV and Aids. The minister has been widely criticised and teased about these statements by medical practitioners and in the media.
| The African potato is just part of the concoction |
The new study ran the results of laboratory tests examining the effects of capsules, tablets and teas infused with African potato and Sutherlandia (cancer bush) on the metabolisation of ARVs.
Both herbs, but the African potato in particular, were found to inhibit the effectiveness of ARVs "significantly". So much so, said the researchers, that "extreme caution" should be taken in treating HIV patients with any herbal "drugs".
They write that their results "highlight the extreme caution that should be taken in introducing herbal drugs into routine care of HIV patients in any setting, including the developing world, and underscore the need for appropriately designed pharmacokinetic studies to unveil the true interaction potential of herbal drugs with antiretroviral drugs".
Pharmacokinetic studies concern the the way drugs are metabolised.
The two herbs were tested after reports by South African researchers in Western Cape last year that they were toxic.
| 'I tell my patients that combining these herbs with their antiretrovirals is a gamble' |
If tests are not carried out on herbs, say the investigators, there could be poisonous drug "interactions", together with failure of the treatment, and the HIV strain could also become resistant to the ARVs.
Dr Rudy Onia, a pharmacologist with the South African Traditional Medicines Research Group at the University of Cape Town, said: "To my knowledge, no evidence currently exists to suggest that these effects, as demonstrated in the laboratory, are of significance within the live clinical context."
But, he added, "research into the clinical significance of this potential interaction should be commissioned as a matter of urgency.
"Until these investigations suggest otherwise, it would be prudent for patients to refrain from using these herbal medicines while being managed with ARVs."
Meanwhile, the government is allowing 27 health-care centres to provide complementary and traditional medicines to HIV-positive patients. This follows a department of health estimate that 70 percent of South Africans consult traditional healers.
But new legislation bans South Africa's 200 000 sangomas from diagnosing and treating terminal diseases such as Aids and cancer. How the government proposes to police the new law is unknown.
Speaking this month at the first international conference on natural products and molecular therapy held at the University of Cape Town, Tshabalala-Msimang urged delegates to expose the split that had arisen between natural medicine and allopathic medicine.
"This is a division fostered by the need to make money from patented drugs through discrediting the use of natural products," she said.
The department of health has channelled a R6-million grant through the Medical Research Council (MRC) for research on the safety, efficacy and quality of traditional medicines used as immune boosters by people living with HIV and Aids.
Dr Francois Venter of the University of the Witwatersrand, who works at a large ARV clinic in Johannesburg, said: "It's a difficult situation. People use the African potato plant and Sutherlandia frequently, as well as a range of other untested medications. We have very little information about the safety of these herbs and also understand very little about their interactions with anti-retrovirals and other drugs.
"This study confirms that we need more research in the area, and the MRC is devoting significant resources to this. Practically, I tell my patients that combining these herbs with their antiretrovirals is a gamble, and that I do not know if it is safe. After that, it becomes their own decision."
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