Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

852 Abstracts 42254-42394

12th World AIDS Conference

Results: The LD50 was established to be >5000 mg/kg ip and >10,000 mg/kg
po in mice. No remarkable adverse reaction was recorded in laboratory animals
within 24 hours. The preliminary data suggest immuno-stimulant activity of the
extract. The sample caused a dose dependent relaxation of both the isolated
guinea pig ileum, and the rabbit jejunum. No anti-TB activity was recorded, but
significant inhibitory activity was noticed against Candida albicans, E. coli and
Pseudomonas aeruginosa. The product appeared to be safe and may be useful
against some opportunistic infections. The relaxant effect on the guinea pig ileum
and rabbit jejunum corroborates the use of the product since this could be beneficial in the treatment of profuse diarrhoea which is frequently noticed in AIDS
patients.
Lesson Learned: Cheaper and safer drugs for the management of HIV/AIDS
can be developed.
S42390 Treating HIV/AIDS: Reported use of complementary
therapies by PHA voluntarily enrolled in an observational
database
Kira Leeb1, G. Robinson2, P. Millson2, K. Luby3, A. Rachlis4. 1HIV Ontario
Observational Database 2075 Bayview, Rm G323, Northyork, Ontario M4N3M5;
2HIV Health Evaluation Unit Toronto ON; 3Private Practice Toronto ON;
4 Sunnybrook Health Science Centre Toronto ON, Canada
Background: The HIV Ontario Observational Database (HOOD) has enrolled
approximately 3000 people living with HIV/AIDS (PHA) in Ontario. PHA enroll
through either their primary care physician or their specialty care clinic. Enrolment
is voluntary and non-nominal. Upon enrolment, PHA complete a questionnaire
(e.g. gender, race, date of birth, risk factors, education, use of social supports
and use of complementary therapies (CTs)) and clinical information (e.g. disease
status, history of illness, use of prescribed medications) is abstracted from their
medical chart. The purpose of the present study is to characterize the differences
between those using and not using complementary therapies and to determine if
use is associated with disease status or demographic characteristics.
Methods: All PHA enrolled in the database were included in the study if both
their personal and clinical information had been received and entered into the
database (n = 2500). Data were queried from the database on the basis of a
variety of demographic and clinical variables and grouped according to those who
currently used any form of CTs, those reporting past or current use of CTs and
those not using any CTs. Simple descriptive statistics and correlations among
various measures of disease status, demographic characteristics and reported
use were calculated.
Results: Based on preliminary analyses, a large percentage (73%) of those
enrolled in the database are using at least one CT. CT use is associated with use
of social supports (p < 0.001) and education (p < 0.001) and no differences are
seen between those using and not using CTs with respect to age, gender, risk
factor and disease state. Most use CTs without consultation with a CT practitioner.
A second cross-sectional survey, given to a sub-sample of those enrolled in the
HOOD, was used to validate reported use of CTs and the Health Utilities Index
was used to better determine the relationship between health status and use of
CTs in the sub-sample.
Conclusions: Complementary therapies are widely used by PHA to deal with
HIV/AIDS related illnesses. Social support and education level appear to be
factors related to use. Many PHA use these therapies without regular supervision
from a CT practitioner. Health care providers should become familiar with the CTs
used by this population so that guidance and information could be provided.
42391 Alternative therapy use among HIV-infected patients of
the inner city
Barbara E. Johnston2, K. Ahmad2, C. Smith2, D.N. Rose3. 1AIDS Center St
Vincents Hospital, 412 Sixth Ave Suite 401 New York, NY10011; 2Mount Sinai
Medical Center, New York, NY; 3Long Island Jewish Medical Center, New Hyde
Park, NY, USA
Background and Purpose: Alternative therapy use by HIV-infected patients is
well known but its use by inner city patients has not been studied.
Method and Patients: A structured interview of 212 urban hospital patients.
Results: Fifty-eight percent of the patients are Latinos, 34% African American,
and 60% are women. Eighty percent regularly use either herbs, plant substances,
alternative treatments: massage, touch, yoga, or acupuncture (25% use acupuncture); 68% use nutritional supplements not prescribed by their physicians; 44%
use plant substances, most commonly garlic and aloe vera; 42% use herbs, most
commonly 'cat's claw,' and 9% regularly use nontraditional healers. Alternative
therapy use was not significantly associated with ethnicity, gender, or CD4 count.
This inner city, mostly minority HIV-infected population has a high prevalence
of alternative therapy use, especially alternative treatments, nutritional supplements not prescribed by their physicians, herbs, and plant substances. Alternative
therapy use was not associated with demographic subgroups or CD4 count.

42392 The role of herbal supplementation in the lives of HIV+
and AIDS patients
Maria Connie Abelardo. 52-18 Van Loon Street, Elmhurst New York City, New
York 11373, USA
Issue: The herbal supplementation as part of the treatment regimen of HIV+ and

AIDS patients requires a standard affordability to each and everyone who needs
these therapy.
Project: A self-administered questionnaire had been applied during the period
of August 1996 to February 1997 to 50 HIV+ and 50 AIDS patients. The questionnaire has been filled out anonymously. Different types of herbal supplements
were listed as cited examples.
Results: Among the HIV+ patients: 70% had improvement in T-cells and 30%
had no change; 80% had improvement in QOL (Quality of life) and 20% had no
change; 90% found herbal supplementation as basic part of treatment regimen
and 10% did not find it helpful; and 100% answered 'yes' to question "Should
health insurance cover these herbal sup'n?" Among the AIDS patients: 60% had
improvement in T-cells and 40% had no change; 90% had improvement in QOL
and 10% had no change in QOL; 90% found herbal supplementation as basic
part of treatment regimen and 10% did not find it helpful; and an overwhelmingly
100% also answered 'yes' to "Should health insurance cover these type of herbal
supplements?". Both groups had stated that they find the herbal supplementation,
although expensive, as 'basic necessity' to their health.
Lessons Learned: Data suggest that herbal supplementation is a part of the
treatment regimen for both HIV+ and AIDS patients. Both groups believe that
health insurance should cover these supplements instead of themselves covering
the costs and thereby improving further their quality of life.
42393 The clinical research on medicinal plants used in HIV
infection: A bibliographic search
Antonio Bianchi1, R. Adamoli2, A. Durante2, A. Saibene1. iC.O.E. Traditional
Medicine Via Lazzoni 8 20124 Milano; 2Centro Poiesis Fondazione Exodus,
20134 Milano, France
Objective: To gather clinics available in scientific literature on medicinal plants
(MP) and on its active compounds (AC) tested/used in HIV infection.
Methods: Bibliographic search on journals, conference proceedings and on
main medical data banks.
Results: Clinical studies on following MP and AC have been found: Allium
s. (ajoene), Aloe v. (acemannan), Buxus s., Curcuma 1. (curcumine), Geissospermum v. (flavopereirine), Glycyrrhiza g. (glyciyrhizin), Grifola f., Lentinus e.
(lentinan), Uncaria t. (oxindole alkaloids), Hypericum p. (hypericine), Melaluca
a., Momordica c. (MAP 30), Trikosanthes k. (trichosantine), Viscum a. For some
MP cited above, studies on antiretroviral activity (through inhibition of main viral
enzymes as reverse transcriptase, protease and integrase, inhibition of proteic
synthesis, LTR, syncytia absorption and formation) and/or in vitro immuno-modulant activity (through increase of IL-2, NK, INF-y, Macrophages, T and B cells
production-or activity) have been noticed in literature. Outcomes of 28 clinical
trials on MP and/or AC with antiretroviral activity (in vitro) involving 1003 persons
and further 14 trials (957 persons involved) with immuno-modulant activity have
been found: a total of 42 testings concerning 1960 persons living with HIV and/or
AIDS. From a study typology point of view it is about 31 clinical trials (8 controlled)
and 11 observational studies; 8 phase I (safety), 23 phase 1/11, 2 phase II and 9
not properly defined ones.
Conclusions: In vitro data, in most cases, have been rigorously obtained and
have been confirmed by various authors, whereas results of clinical researches
are often controversial and/or still incomplete. It is not possible to express any
conclusive consideration with regard to single plants, but documentation on the
whole suggests that MP and AC might be usefully studied in HIV infection.
S42394 Clinical evaluation of efficacy and safety of a new poly
herbal drug in the management of HIV infection
Usha Rani Pingali, M.U.R. Naidu, R.K.R. Takallapalli, S. Jagadishchandra,
V.K. Tangirala. Department of Clinical Pharmacology, N.I.M.S., Hyderabad, India
Objectives: The present study was aimed to evaluate the efficacy and tolerability
of a polyherbal preparation claimed to have immunomodulatory activity in the
management of HIV infection.
Design: Open trial.
Methodology: In the ethically approved open study, 10 patients with HIV infection confirmed by ELISA and Westernblot tests were included to receive 2
capsules of the test drug twice daily. Six patients (4 M&2 F), mean age 30 ~
9 years, with mean duration of symptoms from 3.8 + 1.5 months, completed 6
months course of test drug. During this period, no other antiretroviral drug was
allowed. Symptom evaluation for fever, diarrhoea, anorexia, fatigue, weakness,
nausea, vomiting, herpes, oral thrush, bleeding diathesis, cough, genital ulceration were evaluated using 4 point score, where 0 = none, 1 = mild, 2 = moderate &
3 = severe, before and at monthly evaluation intervals. Lymphocyte phenotyping,
hematological, hepatic and renal biochemical parameters were evaluated before
and after 6 months treatment.
Results: There was good symptomatic improvement in all patients with the
present polyherbal drug. In most patients, the improvement was noticed within
one month. The total symptom scores decreased from 23 to 9. The mean scores
reduced from 1.3 ~ 0.5 to 0.47 ~ 0.15 after 6 months treatment. The average

weight increase was 3.4 ~ 2.2 kg (0-7 kg) after treatment. The lymphocyte
phenotyping values are: CD4 values 217 ~ 56 & 425 ~ 198 U/L before & after
treatment respectively.
Conclusion: Polyherbal test drug showed good improvement in CD4 counts &
other symptoms in HIV patients. Though the present study is limited to 6 patients.
These observations are highly encouraging. Detailed study is in progress.