title: Potential health risks of complementary alternative medicines in HIV patients.
abstract: OBJECTIVE
  To determine the prevalence and purpose of complementary alternative medicines (CAMs) use in people receiving treatment for HIV infection. To identify and quantify potential health risks of CAM use in this population and to explore options for improved pharmacovigilance.
  
  
  METHODS
  Cross-sectional questionnaire survey of 293 patients receiving antiretroviral (ARV) therapy at three specialist HIV out-patient clinics in central London, UK. The use of herbal medicines and supplements was explored, and potentially adverse side effects or significant drug interactions with conventional therapies were identified.
  
  
  RESULTS
  Of the 293 patients included, 61% (n=179) were taking herbal remedies or supplements and 35% (n=103) were using physical treatments. Twenty-seven per cent (n=80) used a combination of both. Twenty per cent (n=59) potentially compromised their HIV management through using CAM therapy. Ten per cent (n=29) were advised to stop their CAMs and 15% (n=43) were made aware of potential drug interactions and adverse effects and were advised to monitor their care.
  
  
  CONCLUSIONS
  There are potentially significant health risks posed by the concomitant use of CAMs in patients taking ARV therapy. Medical practitioners need to be able to identify CAM use in HIV-positive patients and recognize potential health risks. Patients should be encouraged to disclose CAM use to their clinicians and other healthcare professionals.
authors.affiliation: St Bartholomew's Hospital, London, UK. ladenheim@hotmail.com
authors.forename: D
authors.initials: D
authors.lastname: Ladenheim
authors.forename: O
authors.initials: O
authors.lastname: Horn
authors.forename: U
authors.initials: U
authors.lastname: Werneke
authors.forename: M
authors.initials: M
authors.lastname: Phillpot
authors.forename: A
authors.initials: A
authors.lastname: Murungi
authors.forename: N
authors.initials: N
authors.lastname: Theobald
authors.forename: C
authors.initials: C
authors.lastname: Orkin
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D000529:Complementary Therapies / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism; D004347:Drug Interactions; D015658:HIV Infections / Q000188:drug therapy / Q000201:enzymology / Q000628:therapy*; D006801:Humans; D010946:Plants, Medicinal / Q000009:adverse effects; D015995:Prevalence; D011795:Surveys and Questionnaires; D019562:Viral Load
chemical_list: D000276:Adjuvants, Immunologic; D044966:Anti-Retroviral Agents; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human