The Use of Complementary Alternative Medicine in HIV-infected Patients during COVID-19 Pandemic: Its Related Factors and Drug Interactions with Antiretroviral Therapy

Evy Yunihastuti, Teguh Harjono Karjadi, Nafrialdi Nafrialdi, Indah Mediana, Salma Sundari, Andrian Wiraguna, Aljira Fitya Hapsari, Amalia Irsha Adhari, Aulia N. S. Putri Khumaini, Tiara Kumala Putri

Abstract


Background: The use of complementary and alternative medicine (CAM) is widespread among patients with chronic disease despite lack of supporting evidence for most CAM types. Concerned regarding higher risk of COVID-19 for HIV-infected patients, probably increase the use of CAM during COVID-19 pandemic in this population. This study aimed to assess the prevalence and factors related to CAM use among HIV-infected patients during COVID-19 pandemic, then identify drug- to-drug interaction (DDI) of antiretroviral (ARV) drugs with CAM that they used. Methods: The study was conducted in HIV Clinic Cipto Mangunkusumo Hospital in September-October 2021, specifically targeting adults HIV-infected patients routinely using ARV. Demographic and clinical data, including COVID-19 and vaccine history, were taken from clinic survey and hospital medical records data. Results: 554 of 1275 patients (43.5%) reported using any type of ingested CAM during COVID-19 pandemic, mostly vitamins and/or minerals. Factors related to CAM use were history of COVID-19 infection (aOR 2.28; 95% CI 1.65-3.14) and 2-5 years ARV duration compared to more than 10 years (aOR 1.4; 95% CI 1.02–1.91). Five known potential interactions involving 20 patients and two potential weak interactions involving 8 patients were found, but many of other interactions categorized as unknown. Only limited number of patients (3.8%) were aware about the drug interaction between ARV and CAM that they used. Conclusion: CAM was commonly used by HIV-infected patients on ARV during the COVID-19 pandemics, but patient awareness related to CAM-ARV drug interactions was exteremely low.


Keywords


complementary therapies; HIV; COVID-19; herbal; drug interactions

References


National Cancer Institute. Complementary and Alternative Medicine (CAM). https://www.cancer.gov/about-cancer/treatment/cam (2021, assessed 2022 Feb 19).

Abou-Rizk J, Alameddine M, Naja F. Prevalence and characteristics of CAM use among people living with HIV and AIDS in Lebanon: Implications for patient care. Evid Based Complement Alternat Med. 2016;2016:1–11.

Elfahmi, Woerdenbag HJ, Kayser O. Jamu: Indonesian traditional herbal medicine towards rational phytopharmacological use. J Herbal Med. 2014;4(2):51–73.

World Health Organization. Global report on traditional and complementary medicine 2019. Available online http://apps.who.int/bookorders. 2019. Assessed on 2022 Feb 28.

Littlewood R, Vanable P. Complementary and alternative medicine use among HIV positive people: research synthesis and implications for HIV care. AIDS Care 2008;20(8):1002-18.

Littlewood R, Vanable PA. The relationship between CAM use and adherence to antiretroviral therapies among persons living with HIV. Heal Psychol. 2014; 33(7):660-7.

Bahall M. Prevalence, patterns, and perceived value of complementary and alternative medicine among HIV patients: a descriptive study. BMC Complement Altern Med. 2017;17(1):422.

James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Global Health. 2018;3(5):e000895.

Braun LA, Forrester CA, Rawlins MD, et al. Complementary medicine use by people living with HIV in Australia – a national survey. Int J STD AIDS. 2016;27(1):33–8.

Endale Gurmu A, Teni FS, Tadesse WT. Pattern of traditional medicine utilization among HIV/AIDS patients on antiretroviral therapy at a university hospital in northwestern Ethiopia: A cross-sectional study. Evid Based Complement Alternat Med. 2017;2017:1–6.

Kelso-Chichetto NE, Okafor CN, Harman JS, Canidate SS, Cook CL, Cook RL. Complementary and alternative medicine use for HIV management in the State of Florida: medical monitoring project. J Altern Complement Med. 2016;22(11):880–6.

Laar AK, Lartey MY, Ankomah A, et al. Food elimination, food substitution, and nutrient supplementation among ARV-exposed HIV-positive persons in Southern Ghana. J Health Popul Nutr. 2018;37(1):26.

Kalichman SC, Cherry C, White D, et al. Use of dietary supplements among people living with HIV/AIDS is associated with vulnerability to medical misinformation on the internet. AIDS Res Ther. 2012;9(1):1.

Permatasari J, Hasina H, Pratama S. Studi penggunaan complementary and alternative medicine (CAM) pada ODHA di Yayasan Kanti Sehati Sejati kota Jambi. J Endurance. 2020;5(1):105.

Nugraha RV, Ridwansyah H, Ghozali M, Khairani AF, Atik N. Traditional herbal medicine candidates as complementary treatments for COVID-19: A review of their mechanisms, pros and cons. Evid Based Complement Alternat Med. 2020;2020:1–12.

Rokhmah D, Ali K, Putri SMD, Khoiron K. Increase in public interest concerning alternative medicine during the COVID-19 pandemic in Indonesia: A google trends study. F1000Res. 2021;9:1201.

Chang CC, Crane M, Zhou J, et al. HIV and co-infections. Immunol Rev. 2013;254(1):114–42.

Ssentongo P, Heilbrunn ES, Ssentongo AE, et al. Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis. Sci Rep. 2021;11(1):6283.

Brooks KM, George JM, Kumar P. Drug interactions in HIV treatment: complementary & alternative medicines and over-the-counter products. Expert Rev Clin Pharmacol. 2017;10(1):59–79.

Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia nomor HK.01.07/MENKES/90/2019 tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana HIV 2019.

Liverpool HIV Interactions. https://www.hiv-druginteractions.org/ (assessed 2022 Feb 28].

Danwang C, Noubiap JJ, Robert A, Yombi JC. Outcomes of patients with HIV and COVID-19 co-infection: a systematic review and meta-analysis. AIDS Res Ther. 2022;19(1):3.

Dehghan M, Ghanbari A, Ghaedi Heidari F, Mangolian Shahrbabaki P, Zakeri MA. Use of complementary and alternative medicine in general population during COVID-19 outbreak: A survey in Iran. J Integr Med. 2022;20(1):45–51.

Paudyal V, Cadogan C, Fialová D, et al. Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries. Res Social Admin Pharm. 2021;17(8):1507–17.

Pullen MF, Skipper CP, Hullsiek KH, et al. Symptoms of COVID-19 outpatients in the United States. Open Forum Infect Dis. 2020;7(7):ofaa271.

Lorenc A, Robinson N. A Review of the use of complementary and alternative medicine and HIV: Issues for patient care. AIDS Patient Care STDs. 2013;27(9):503–10.

Bordes C, Leguelinel-Blache G, Lavigne J-P, et al. Interactions between antiretroviral therapy and complementary and alternative medicine: a narrative review. Clin Microbiol Infect. 2020;26(9):1161–70.

Song I, Borland J, Chen S, et al. Effect of food on the pharmacokinetics of the integrase inhibitor dolutegravir. Antimicrob Agents Chemother. 2012;56(3):1627–9.

Song I, Borland J, Arya N, Wynne B, Piscitelli S. Pharmacokinetics of dolutegravir when administered with mineral supplements in healthy adult subjects. J Clin Pharmacol. 2015;55(5):490–6.

Dolutegravir (Tivicay) Package Insert | DAIDS Regulatory Support Center (RSC) [Internet]. [cited 2022 Feb 28]. Available from: https://rsc.niaid.nih.gov/clinical-research-sites/dolutegravir-tivicay-package-insert

Duncan A, Mills J. An unusual case of HIV virologic failure during treatment with boosted atazanavir. AIDS. 2013;27(8):1361–2.

Naccarato M, Yoong D, Gough K. A potential drug–herbal interaction between Ginkgo biloba and efavirenz. J Int Assoc Physicians AIDS Care. 2012;11(2):98–100.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.