Many HIV-positive patients in London risking their health by use of alternative therapies

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One-in-ten patients at large HIV clinics in London are taking complementary or alternative treatments that were potentially dangerous to their health, according to a study presented to the Sixteenth International AIDS Conference in Toronto last week. Most of the patients are taking alternative treatments that can cause unpleasant side-effects in patients with weakened immunity, but some are taking therapies known to interact with anti-HIV treatment.

Complementary and alternative remedies are widely used by HIV-positive individuals, but this is potentially concerning as not only do many treatments interact with antiretroviral therapy but patients often do not tell their HIV doctor or pharmacist about over-the-counter or complementary therapies that they are taking.

Investigators at several large HIV treatment centres in London wished to determine widely used complementary and alternative remedies were amongst patients taking anti-HIV therapy. Patients were therefore asked to complete a questionnaire detailing their use of such products.

Glossary

drug interaction

A risky combination of drugs, when drug A interferes with the functioning of drug B. Blood levels of the drug may be lowered or raised, potentially interfering with effectiveness or making side-effects worse. Also known as a drug-drug interaction.

Responses were received from 293 patients. Almost two-thirds were taking herbal or alternative remedies and a little over a third were using physical therapies such as massage.

A total of 11% of patients were advised to discontinue the use of complementary of alternative therapies; 8% because of potentially dangerous side-effects (from echinacea) and 3% because they were taking products that can lower the amount of antiretrovirals in the blood (garlic supplements, kava and St John’s wort). A further 14% of patients were advised to use alternative and complementary products with caution, 2% of because of the potential for side-effects and 12% because of the risk of an interaction with their HIV therapy.

Of the patients using alternative and complementary therapies, only 54% had discussed this with a healthcare provider.

“Eleven percent of patients in our cohort were potentially seriously compromising their HIV management by taking complementary and alternative medicines”, emphasise the investigators. They add that the study underlines the importance of doctors being aware of complementary medicine use by their patients as well as the need for patients to disclose the use of such products to their doctor. They conclude that pharmacists have an important role in updating both doctors and patients about the potential risks arising from the use of herbal and complementary medicines.

References

Ladenheim D et al. Potential health risks of complementary alternative therapies in HIV-positive patients. Sixteenth International AIDS Conference, Toronto, abstract MOPE0219, 2006.