title: Impact of African herbal medicines on antiretroviral metabolism.
abstract: We examined the effects of two African herbal medicines recommended for HIV/AIDS patients on antiretroviral metabolism. Extracts from Hypoxis and Sutherlandia showed significant effects on cytochrome P450 3A4 metabolism and activated the pregnane X receptor approximately twofold. P-glycoprotein expression was inhibited, with Hypoxis showing 42-51% and Sutherlandia showing 19-31% of activity compared with verapamil. Initiating policies to provide herbal medicines with antiretroviral agents may put patients at risk of treatment failure, viral resistance or drug toxicity.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Edward
authors.initials: E
authors.lastname: Mills
authors.forename: Brian C
authors.initials: BC
authors.lastname: Foster
authors.forename: Rolf
authors.initials: R
authors.lastname: van Heeswijk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Phillips
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
authors.forename: Blair
authors.initials: B
authors.lastname: Leonard
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kosuge
authors.forename: Isadore
authors.initials: I
authors.lastname: Kanfer
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism; D044966:Anti-Retroviral Agents / Q000378:metabolism*; D001189:Aryl Hydrocarbon Hydroxylases / Q000378:metabolism; D051544:Cytochrome P-450 CYP3A; D007887:Fabaceae; D041743:Herb-Drug Interactions; D006801:Humans; D027802:Hypoxis; D010089:Oxidoreductases, N-Demethylating / Q000378:metabolism; D008517:Phytotherapy / Q000379:methods*; D010936:Plant Extracts / Q000009:adverse effects*; D000077297:Pregnane X Receptor; D018160:Receptors, Cytoplasmic and Nuclear / Q000378:metabolism; D011987:Receptors, Steroid / Q000378:metabolism; D014700:Verapamil / Q000378:metabolism
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D044966:Anti-Retroviral Agents; D010936:Plant Extracts; D000077297:Pregnane X Receptor; D018160:Receptors, Cytoplasmic and Nuclear; D011987:Receptors, Steroid; D014700:Verapamil; D001189:Aryl Hydrocarbon Hydroxylases; D051544:Cytochrome P-450 CYP3A; D010089:Oxidoreductases, N-Demethylating