HIV/ AIDS

Knowledge of safety and herb-drug interations amongst HIV+ individuals: a focus group study.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Knowledge of safety and herb-drug interations amongst HIV+ individuals: a focus group study. Anonymous (not verified) Tue, 08/24/2021 - 11:42

OBJECTIVE: To determine how HIV+ individuals access safety and knowledge of drug interactions related to complementary and alternative medicine (CAM). METHODS: We conducted two separate focus group sessions with HIV+ users of complementary therapies. A total of 8 men participated at an urban health centre. Focus group sessions were audio taped and transcribed verbatim. Analysis was conducted independently and in duplicate, using thematic analysis. RESULTS: All focus group participants described their use of CAM as very important for their health maintenance, giving them a feeling of empowerment in their health care. Potential side effects and safety issues were indicated as major concerns for treatment decisions, but the participant's knowledge of safety issues involved in CAM care for HIV+ patients was limited. The sources used by the participants to gather information regarding safety and interactions with medications were varied but included: their CAM providers, their physicians, books, resources from AIDS Service Organizations, the internet and health food stores. Participants acknowledged that appraising the quality of such information is difficult. CONCLUSIONS: The participants in this study had a strong trust in CAM and used a wide variety of sources to gather information on CAM safety, though their knowledge base was poor. As the use of CAM grows, further research on how to disseminate reliable information on safety and efficacy to this potentially vulnerable population is required. PMID: 15520476

Author

Leonard B, Huff H, Merryweather B, Lim A, Mills E.

Citedate

2004-01-01

Citation

Can J Clin Pharm, 2004;11(2):e227-31.

Affiliations

University of Toronto

Taxonomy

HIV/ AIDS

Vitamin supplementation for prevention of mother-to-child transmission of HIV and pre-term delivery: a systematic review.

Anonymous — Tue, 24 Aug 2021 15:42:02 +0000

Vitamin supplementation for prevention of mother-to-child transmission of HIV and pre-term delivery: a systematic review. Anonymous (not verified) Tue, 08/24/2021 - 11:42

BACKGROUND: Observational studies have suggested that low serum vitamin levels are associated with increased mother-to-child transmission (MTCT) of HIV and increased preterm delivery. We aimed to determine the efficacy of vitamins on the prevention of MTCT and preterm delivery by systematically reviewing the available randomized controlled trials [RCTs]. We conducted systematic searches of 7 electronic databases. We extracted data from the RCTs independently, in duplicate.RESULTS: We included 4 trials in our review. Of the three trials on Vitamin A, two suggested no difference in MTCT, while the third and largest trial (n = 1078) suggested an increased risk of MTCT (Relative Risk 1.35, 95% Confidence Interval [CI], 1.11-1.66, P = 0.009). Two of the vitamin A trials addressed the impact of supplementation on pre-term delivery; one suggested a benefit (RR 0.65, 95% CI, 0.44-0.94) and the other no difference. All three vitamin A trials found no significant effect on infant mortality at 1 year. Of the two trials that looked at multivitamin use, only one addressed the prevention of MTCT, and found a non-significant RR of 1.04 (95% CI, 0.82-1.32). Two of the multivitamin trials found no significant effects on pre-term delivery. The single multivitamin trial examining children's mortality at 1 year yielded a non-significant RR of 0.91 (95% CI, 0.17-1.17).CONCLUSION: Randomized trials of vitamins to prevent MTCT have yielded conflicting results without strong evidence of benefit and have failed to exclude the possibility of harm. PMID: 15877818

Author

Mills EJ, Wu P, Seely D, Guyatt GH.

Citedate

2005-01-01

Citation

AIDS Res Ther. 2005;2(1):4.

Affiliations

McMaster University

Publication

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1131887/

Taxonomy

HIV/ AIDS

African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology.

Anonymous — Tue, 24 Aug 2021 15:42:00 +0000

African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology. Anonymous (not verified) Tue, 08/24/2021 - 11:42

In Africa, herbal medicines are often used as primary treatment for HIV/AIDS and for HIV-related problems. In general, traditional medicines are not well researched, and are poorly regulated. We review the evidence and safety concerns related to the use of two specific African herbals, which are currently recommended by the Ministry of Health in South Africa and member states for use in HIV: African Potato and Sutherlandia. We review the pharmacology, toxicology and pharmacokinetics of these herbal medicines. Despite the popularity of their use and the support of Ministries of Health and NGOs in some African countries, no clinical trials of efficacy exist, and low-level evidence of harm identifies the potential for drug interactions with antiretroviral drugs. Efforts should be made by mainstream health professionals to provide validated information to traditional healers and patients on the judicious use of herbal remedies. This may reduce harm through failed expectations, pharmacologic adverse events including possible drug/herb interactions and unnecessary added therapeutic costs. Efforts should also be directed at evaluating the possible benefits of natural products in HIV/AIDS treatment. PMID: 15927053

Author

Mills E, Cooper C, Seely D, Kanfer I.

Citedate

2005-01-01

Citation

Nutrition Journal, 2005;4(1):19.

Affiliations

McMaster University

Publication

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1156943/

Taxonomy

HIV/ AIDS

Acupuncture for treatment of HIV associated acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome)

Anonymous — Tue, 24 Aug 2021 15:41:59 +0000

Acupuncture for treatment of HIV associated acute inflammatory demyelinating polyradiculoneuropathy (Guillain-Barré syndrome) Anonymous (not verified) Tue, 08/24/2021 - 11:41

Guillain-Barré syndrome (GBS) can be associated with human immunodeficiency virus (HIV) infection. Treatment with acupuncture may modulate immune function and restore sensation and motor function to affected areas. To describe an HIV-positive patient with GBS who received acupuncture treatment for amelioration of GBS symptoms. The patient was diagnosed with HIV infection in 1989. In January 1999 at age 40 years, he experienced a 3-week progression to nadir of bilateral paresthesias and motor impairment that ascended to the chest and then to the head, causing palpitations, partial ophthalmoplegia, and impaired taste sensation. Initial acupuncture at bilateral points GB 34, GB 39, PC 6, and KI 3 (addition of GV 4, GV 3, BL 23, and BL 40 later) for 30 minutes each. Improvement in sensation and motor function as well as related GBS symptoms. After 2 acupuncture treatments, the patient reported increased sensation in his feet as well as improved coordination, balance, and confidence in mobility. After 4 treatments, he reported dramatic improvement in sensation. With each subsequent treatment, the patient reported increasing energy and self-confidence. At 3 months, he reported that total recovery was approximately 75%. The most significant change was dramatic improvement in toe flexion, ankle extension, and sensation in his feet. After 1 year of treatment, the patient reported an overall total subjective recovery of 90%, including an absence of motor and sensory impairments. In this HIV-positive patient, acupuncture appears to have dramatically accelerated recovery from GBS, allowing greater mobility, self-confidence, social functioning, and overall quality of life. Further investigation into the efficacy of acupuncture for GBS is warranted. PMID: 18204101

Author

Huff H, Cooley K, Waller N.

Citedate

2008-01-01

Citation

Medical Acupuncture, 2008;20(3):191-5.

Affiliations

Canadian College of Naturopathic Medicine

Publication

http://online.liebertpub.com/doi/abs/10.1089/acu.2008.0624

Taxonomy

HIV/ AIDS

Effect of selenium supplementation on CD4 T-cell recovery, viral suppression, morbidity and quality of life of HIV-infected patients in Rwanda: study protocol for a randomized controlled trial.

Anonymous — Tue, 24 Aug 2021 15:41:56 +0000

Effect of selenium supplementation on CD4 T-cell recovery, viral suppression, morbidity and quality of life of HIV-infected patients in Rwanda: study protocol for a randomized controlled trial. Anonymous (not verified) Tue, 08/24/2021 - 11:41

BACKGROUND: Low levels of serum selenium are associated with increased risk of mortality among HIV+ patients in East Africa. We aim to assess the effect of selenium supplementation on CD4 cell count, HIV viral load, opportunistic infections, and quality of life in HIV-infected patients in Rwanda. METHODS AND DESIGN: A 24-month, multi-centre, patient and provider-blinded, randomized, placebo-controlled clinical trial involving 300 pre-antiretroviral therapy (ART) HIV-infected patients will be carried out at two sites in Rwanda. Patients > 21 years of age with documented HIV infection, CD4 cell count of 400-650 cells/mm3, and not yet on ART will be recruited. Patients will be randomized at each study site using a randomized block design to receive either the selenium micronutrient supplement or an identically appearing placebo taken once daily. The primary outcome is a composite of time from baseline to reduction of CD4 T lymphocyte count below 350 cells/mm3 (confirmed by two measures at least one week apart), or start of ART, or the emergence of a documented CDC-defined AIDS-defining illness. An intention-to-treat analysis will be conducted using stepwise regression and structural equation modeling. DISCUSSION: Micronutrient interventions that aim to improve CD4 cell count, decrease opportunistic infections, decrease HIV viral load, and ultimately delay initiation of more costly ART may be beneficial, particularly in resource-constrained settings, such as sub-Saharan Africa. Additional trials are needed to determine if micro-supplementation can delay the need for more costly ART among HIV-infected patients. If shown to be effective, selenium supplementation may be of public health importance to HIV-infected populations, particularly in sub-Saharan Africa and other resource-constrained settings.

Author

Kamwesiga J, Mutabazi V, Kayumba J, Tayari JC, Smyth R, Fay H, Umurerwa A, Baziruwiha M, Ntizimira C, Murebwayire A, Haguma JP, Nyiransabimana J, Habarurema D, Mukarukundo V, Nzabandora JB, Nzamwita P, Mukazayire E, Mills EJ, Seely D, McCready DJ, Warren

Citedate

2011-01-01

Citation

Trials. 2011 Aug 13;12:192. doi: 10.1186/1745-6215-12-192.

Affiliations

The Canadian College of Naturopathic Medicine

Publication

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182905/

Taxonomy

HIV/ AIDS

Micronutrient Deficiency and Treatment Adherence in a Randomized Controlled Trial of Micronutrient Supplementation in ART-Naive Persons with HIV

Anonymous — Tue, 24 Aug 2021 15:41:53 +0000

Micronutrient Deficiency and Treatment Adherence in a Randomized Controlled Trial of Micronutrient Supplementation in ART-Naive Persons with HIV Anonymous (not verified) Tue, 08/24/2021 - 11:41

INTRODUCTION: The MAINTAIN study is an on-going RCT comparing high-dose micronutrient and anti-oxidant supplementation versus recommended daily allowance (RDA) vitamins in slowing HIV immune deficiency progression in ART-naïve people with HIV infection. OBJECTIVE: We planned analysis of the first 127 participants to determine the baseline prevalence of serum micronutrient deficiencies and correlates, as well as tolerance and adherence to study interventions. METHODS: Participants receive eight capsules twice daily of 1) high-dose or 2) RDA supplements for two years and are followed-up quarterly for measures of immune deficiency progression, safety and tolerability. Regression analysis was used to identify correlates of micronutrient levels at baseline. Adherence was measured by residual pill count, self-report using the General Treatment Scale (GTS) and short-term recall HIV Adherence Treatment Scale (HATS). RESULTS: Prior micronutrient supplementation (within 30 days) was 27% at screening and 10% of study population, and was not correlated with baseline micronutrient levels. Low levels were frequent for carotene (24%

Author

Balfour L, Spaans JN, Fergusson DA, Huff H, Mills EJ, la Porte CJ, Walmsley S, Singhal N, Rosenes R, Tremblay N, Gill MJ, Loemba H, Brian Conway B, Rachlis A, Ralph E, Loutfy M, Mallick R, Moorhouse R, Cameron DM

Citedate

2014-01-01

Citation

PLoS One. January 21, 2014. DOI: 10.1371/journal.pone.0085607

Affiliations

Canadian College of Naturopathic Medicine, University of Ottawa, Ottawa Hospital Research Institute, University of British Columbia, University of Calgary

Publication

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0085…

Taxonomy

HIV/ AIDS

Vitamin D and progression of carotid intima-media thickness in HIV-positive Canadians

Anonymous — Tue, 24 Aug 2021 15:41:52 +0000

Vitamin D and progression of carotid intima-media thickness in HIV-positive Canadians Anonymous (not verified) Tue, 08/24/2021 - 11:41

Objectives
Based on a growing body of evidence implicating low vitamin D status in the development of cardiovascular disease (CVD), we hypothesized that in Canadian HIV-positive adults, low 25-hydroxyvitamin D (25(OH)D) concentration would be associated with increased subclinical vascular disease progression.

Methods
We prospectively studied the relationship between baseline 25(OH)D and subsequent progression of carotid intima-media thickness (CIMT) between 2002 and 2011, in the Canadian HIV Vascular Study using stored blood specimens.

Results
Of the 128 participants, 89.1% were men, the mean age (standard deviation [SD]) was 46.5 (8.2) years, 93.8% were white, and 36.7% were current smokers. Mean (SD) annual CIMT follow-up was 5.9 (1.8) years (maximum 8.5 years), providing approximately 750 patient-years of follow-up. Mean (SD) CIMT progression was 0.027 (0.030) mm/year. Mean (SD) 25(OH)D was 95.0 (46.9) nmol/L. Only 13.3% of participants were vitamin D deficient (25(OH)D
Conclusions
Baseline 25(OH)D was associated with CIMT progression in this relatively vitamin D replete, predominately white and male, Canadian HIV-positive population. Future research needs to establish causality as this may warrant more targeted screening or supplementation.

Read the full study.

Author

H Huff, AT Merchant, E Lonn, E Pullenayegum, F Smaill and M Smieja

Citedate

2017-11-09

Citation

DOI: 10.1111/hiv.12563

Publication

HIV Medicine

Taxonomy

HIV/ AIDS