A recent study by Nigerian researchers has demonstrated how an herbal therapy could reduce the viral loads and increase CD4 counts of Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) patients.
A CD4 count measures the number of CD4 cells in your blood. It's used to check the immune system function in people with HIV.
According to the study by researchers from the Department of Plant Science and Technology, Faculty of Natural Sciences, University of Jos, and OLA Hospital Laboratory, Jos, Plateau State, the herbal treatments were effective in managing opportunistic infections and other complications in persons living with HIV/AIDS.
The researchers, which include: M. K. Elujoba, C. I. C. Ogbonna, F. Chinyere, F. O. Elujoba, E. Ayanda and E. Newton, concluded: "The present study showed that combined herbal therapy could bring the reduction in the viral load and increase CD4 counts of HIV/AIDS patients. It similarly expresses good antioxidant activities in vitro when compared to the commercial reference Butylated hydroxyl toluene (BHT).
"Herbal treatment should be encouraged. It should act as the supplementary treatment for patients and should not replace the conventional Anti Retroviral Therapy (ART) therapy. Increases in adherence rate should also be advocated for a better response as non adherence to the treatment regime may present a decrease in CD4 count and an increase in viral load."
The study titled "The Effects of a Mixture of Extracts from Indigenous Herbs on HIV/AIDS Patients Employing CD4+ T Lymphocyte Counts and Viral Load Reductions as Assessment Indices" was published in the May 2018 edition of the journal International STD Research & Reviews.
The herbal preparation, according to the researchers, include combination of fresh Ananas comosus (pineapple) juice (500 millilitres/ml), Citrullus lanatus (watermelon) juice (2.2 litres/L) and Citrus medica (lemon) juice (200 ml) were extracted using a blender (Model BL330, Kenwood, Hong Kong, China suspended in coconut oil (250 ml).
Aqueous extracts of Zobo (Hibiscus sabdariffa) was prepared by extracting 100 gramme in 500 ml of distilled water from which 200ml was mixed in the previous preparation.
Garlic (7000mg), Moringa oligofera (250g) and Artemisia annua leaves (250 g) were mixed with the whole preparation and then suspended in 1L of Tualing Honey. The herbal combination was dispensed in sterile plastic containers and refrigerated.
The volunteers were asked to take two tablespoons thrice daily (approximately 10 ml).
Garlic has been found to be effective against the opportunistic infections of HIV/AIDS patients. Such opportunistic diseases include herpes, tuberculosis and sexually transmitted infections.
Moringa leaf has been identified as a valuable nutritional component, which enhances the immune system.
Moringa leaves have also been reported to possess powerful anti-oxidants that can help prevent or delay some complications arising from AIDS.
Artemisia annua improves the general condition of the patients living with HIV/AIDS, improving their appetite, weight gain, and healing of opportunistic infections associated with AIDS.
The study was edited by Jose Eduardo Serrao, Professor, Department of General Biology, Federal University of Viçosa, Brazil and reviewed by: Ashok Pandey, Child Sight Foundation Global, Bangladesh; Hendra Van Zyl, South Africa; Bora Ekinci, Turkey; and Johnstone J. Kumwenda, Malawi.
Until now, HIV infection is treated in some part of Africa using different herbal combinations.
The study aimed at determining the effects of herbal extracts on HIV/AIDS patients and to access its antioxidant effects in vitro. The extract was made from selected fruits, leaves and mixed with honey.
The herbal mixture was employed based on the claims by indigenous Biotechnologist (Medical Botany Practitioners) that such extracts were effective in HIV/AIDS management.
A total number of 95 volunteers' from Jos North, Jos South and Mangu Local Government Areas, Plateau State, Nigeria were therefore chosen for this study.
All the study subjects were adequately diagnosed prior to the study to ascertain their HIV/AIDS positivity status, CD4 counts and viral load baselines. They were further divided into age brackets to find out the age brackets that responded best to the treatment.
The response of the patients was monitored using the CD4 counts increase and viral load reductions as indices at 6th, 12th, 18th and 24th-month intervals.
Significant improvements were recorded in viral load reductions and CD4 counts in all the age groups after the 18th month except for the age group 20 - 29 years.
The active age group (20 - 49 years) had a cumulative incidence of 88 per cent of the total study population.
The highest percentage adherence of 83 per cent was recorded in 40 - 49 years volunteers while the highest non-adherence was recorded as 64 per cent in 50 - 59 years volunteers.
The herbal mixture possesses good in vitro antioxidant effect when compared with BHT.
Despite the breakthroughs in the development of effective antiretroviral (ARV) drugs, a resistance of HIV to some used antiretroviral drugs poses the challenge to therapeutic failures in people treating HIV/AIDS.
Several treatment regimens may thus be needed in the effective treatment of HIV, making it a challenging task.
Conventional HIV/AIDS management therefore among the methods is widely employed.
The antiretroviral administration, including the conventional options, could have significant impact in the reduction of morbidity and mortality that stem from the HIV infection.
Several alternative therapies have been employed in the management of HIV/AIDS as supplements to the widely used conventional ART.
Given the chronicity and the impact of HIV related diseases on quality of life of patients with HIV/AIDS, and in view of the fact that the virus mutates very easily, it has become imperative to seek alternative therapies.
Thus, herbal medicines have been used globally to seek for alternative treatments to HIV/AIDS and could be effective in the management of the disease.
It has been reported that more than 70 per cent of HIV positive people prefer alternative medicine as a better way of management of the AIDS virus.
Some patients have resolved to alternative methods of treatments of HIV/AIDS infection instead of the standard and widely used conventional methods.
The aim of this study was therefore designed to find out the effects of administration of extracts of some indigenous herbs for HIV/AIDS patients employing viral load reduction and increase in CD4 counts as assessment indices, as well as assessing its antioxidant potentials.
The researchers explained: "... In an earlier report also by Elujoba et al., antiretroviral (ART) drug such as Nevirapine (NVP), Efavirenz (EFV), Zidovudine (AZT) and others was shown to reduce the viral load of HIV/AIDS patients after six months of treatment.
"However, the study with herbal combination therapy, a combination of some fruits and leaves with acclaimed anti HIV activities suspended in honey showed a similar reduction in viral load after 18 months of treatment in all age groups except the age group 20 -29 years.
"The viral load reduction rate recorded could be due to certain plant constituents with potent immune system stimulator and antiviral components.
Many herbal remedies have been documented to be useful in HIV infection. They have been found to inhibit one or more steps in HIV replication.
"The combined herbal treatment had no significant effect on the CD4 counts of volunteers from the age groups of 20 -29 years while the best effect of the herbal treatment was recorded in the age group 40 -49 years.
The non-significant improvement in CD4 count of age group 20 -29 years could be contributed by non-adherence rate of the groups, which was 21 per cent.
The two age groups of 30 -39 and 40 -49 years showed an impressive adherence rate of 81 per cent and 83 per cent respectively.
"Individual components of the combined herbal treatment could be increased for better performance as there are no particular restrictions to variation in the herb combination.
Extracts included in the study showed significant improvement at the latter stage of the study.
"Several herbal components have been reported to be of great benefit in HIV/AIDS. For example, garlic may help strengthen the immune system in HIV.
Acemannan, one of the constituents of the herb Aloe vera, has shown some promise in test tube and animal studies for stimulating immunity and inhibiting the growth of viruses, including HIV.
"Patients living with HIV/AIDS have a weakened immune system due to the effect of the virus. They also lost appetite.
Some conventional medicines change the taste of food and reduce appetite. Herbal medicines and spices have been found to improve digestion and stimulate appetite.
"The prevalence of HIV/AIDS varies from state to state in Nigeria. Despite the availability of free Highly Active Antiretroviral Therapy (HAART), Nigerians still go in search of alternative treatment/management options for the HIV by visiting herbal medicine practitioners.
This has paved the way for the documentation of different herbal remedies with active antiretroviral properties.
"As stated earlier, some of this herbal remedies has been found to inhibit one or more steps in the replication of the virus.
Examplesinclude tropical liana plant (Ancistrocladus korupensis) which inhibit reverse transcriptase and HIV induced cell fusion.
Also, coumarins from Calophyllum lanigerum were found to be a potent non-nucleoside reverse transcriptase inhibitor.
"Other herbal remedies used in HIV are aimed at treating opportunistic infections that are occasioned in HIV, while other actively boost the immune system by increasing CD4 lymphocyte count in HIV.
Several other plants with one or more beneficial effects in the treatment of HIV/AIDS have been documented.
"Phytochemicals can also be referred to as phytonutrients. They are found in fruits, vegetables, whole grains, legumes, beans, herbs, spices, nuts, and seeds and are classified according to their chemical structures and functional properties.
Research in the field of phytochemistry has demonstrated that foods and beverages rich in phytochemicals may help prevent diseases.
The richness of the herbal mixture in the various phytochemical could be responsible for the reduced viral load and CD4 lymphocyte counts.
"The herbal mixture contains all the phytochemicals tested for except Tannin and Phlobatannins. This was also from the richness of the individual constituents that makeup the herbal mixture as seen from Tables.
Benefits of antioxidant in HIV replication has been demonstrated in vitro. HIV replication was promoted by Hydrogen peroxide, which a strong oxidant.
The infected cells also release gene-stimulating cellular proteins called nuclear factor kappa B (NFkB).
The effect observed with the strong oxidant was however counteracted by the addition of N acetyl cysteine, which is a known antioxidant.
The strong antioxidant nature of the herbal mixture could be one of the effects observed in increased CD4 counts and reduced viral load replication over the period of study.
"Vitamin C is one of the components of the herbal mixture used in the study. It is a known and widely used antioxidant. It has been reported to play a significant role in reducing HIV replication; it blocks some specific enzymes that HIV requires to complete its lifecycle. Ascorbic acid lowers HIV reverse transcriptase activity by over 99 per cent and a type of antigen known as p24 antigen by 90 per cent."