The impact of herbal remedies on adverse effects and quality of life in HIV-infected individuals on antiretroviral therapy

Nyashadzashe Bepe,Tinashe Mudzviti,Samuel Gavi,Charles C Maponga,Nathan Madanhi,Gene D Morse

doi:10.3855/jidc.1415

Abstract

Use of herbal remedies among HIV-infected individuals in Africa increased in the past decade, mainly due to traditional beliefs and at times inconsistent access to antiretroviral drugs. In Zimbabwe, accessibility and availability of antiretroviral drugs has increased in recent years; however, the use of herbal remedies remains high. This study was conducted to determine the impact of concomitant use of herbal remedies with antiretroviral drugs on adverse events and on quality of life. A convenient sample of HIV positive patients at Parirenyatwa group of hospitals' Family Care Clinic (Harare, Zimbabwe) was enrolled. A questionnaire was used to collect data on the adverse event experiences of the patients using herbal remedies for their HIV, as well as the types of herbal remedy used. Quality of life index was measured using an HIV/AIDS targeted quality of life (HAT-QOL) tool developed by the World Health Organization. Abdominal pain (odds ratio = 2.7, p-value = 0.01) and rash (odds ratio = 2.5, p-value = 0.02) had significant associations with using herbal remedies during antiretroviral therapy. Improved quality of life index was not significantly associated with herbal remedy use during antiretroviral therapy. There is evidence to suggest that some traditional herbal remedies used in Zimbabwe may increase incidence of certain types of adverse events when used in combination with antiretroviral drugs. Use of herbal drugs in combination with antiretroviral therapy does not significantly improve quality of life index in comparison to antiretroviral drug use only.

Highlights

Use of herbal remedies among HIV-infected individuals in Africa increased in the past decade, mainly due to traditional beliefs and at times inconsistent access to antiretroviral drugs
These estimates show the extent of the problems HIV/AIDS continues to cause in subSaharan African countries, and the need for improved management and prevention methods to control the disease
Sixty-three patients were assessed for quality of life using the HIV/AIDS targeted quality of life (HAT-Quality of life (QOL)) instrument

Summary

Introduction

Use of herbal remedies among HIV-infected individuals in Africa increased in the past decade, mainly due to traditional beliefs and at times inconsistent access to antiretroviral drugs. In sub-Saharan Africa, 22.4 million adults and children are currently living with HIV/AIDS, representing more than 60% of the global burden of the disease [1] These estimates show the extent of the problems HIV/AIDS continues to cause in subSaharan African countries, and the need for improved management and prevention methods to control the disease. The advent of HIV/AIDS in Zimbabwe in the mid-1980s increased the popularity and use of herbal remedies because antiretroviral drugs were not available at that time [2]. A study in western Uganda found that 38% of HIV positive patients used traditional medicines and antiretroviral drugs at the same time for the management of HIV infection [4], and the major reasons for use of traditional medicines were perceived additional efficacy, improvement in quality of life, and a feeling of control over the disease. The most commonly used herbal remedies in Southern Africa are Hypoxis hemerocallidea (common name: African potato), and Sutherlandia [4]

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Discussion

Conclusion