An investigation into the effects of concurrent antiretroviral and African traditional medicines on the CD4 count and viral load of HIV infected persons in eThekwini metropolitan area.

Abstract

Background – Traditional Medicines (TM) are often used by people living with HIV/AIDS (PLWA) alone or in combination with antiretroviral therapy (ART) to combat illnesses associated with HIV or the side effects of ART. Very few studies on clinical subjects have been carried out to find out the effects of co-administration of TM with ART Aim To investigate the effects of concurrent use of prescribed antiretroviral medicines (ARVs) and African Traditional medicines (ATM) on the CD4+ lymphocyte Count and Viral Load (VL) of PLWA in the eThekwini Metropolitan area. Method: A descriptive and exploratory study was carried out in two phases at four health facilities offering ART in the eThekwini metro. Phase 1 was a cross sectional descriptive study aimed at collecting information on patient demographics and ATM use. Phase 2 of the study was a longitudinal study which involved collection of data from the patient’s charts using a case report form. The data was collected retrospectively and prospectively in phase 2. Results: 281 patients met the inclusion criteria, gave consent to participate in the study and had usable information in their patient files. The majority of the participants were females (194/281, 69.9%) and almost all (272/281, 96.8%) were of African ethnicity and resided in a local township (64.4%). Fourteen out of the 281 (14/281 4.98%) patients reported concurrent use of ATM with ARVs during the study period. The most commonly used ATM was the African potato (9/14, 64.3%) followed by Sutherlandia (5/14, 21.4%), StamettaTM and uBhejani. The differences between the two means in the cohort taking ARV alone (–ATM) and the cohort which used ATM and ARVs concurrently (+ATM) at each CD4+ cell count measure were not significant at 5% level for Time 0 (p=0.18), Time 2 (p=0.26) and Time 3 (p=0.09). The differences between the two means in the –ATM and +ATM groups were significant at 5% level for Time 0 (p=0.013), marginally significant at Time 1 (p=0.048), significant at Time 2 (p=0.040) and not significant at Time 3 (p=0.069). Conclusion: Concurrent ARV and ATM use is quite low (4.98%) and this may indicate efficient pre-counselling efforts by healthcare professionals before ARV initiation. This study shows that there are no significant differences in CD4+ and inconclusive effects on VL, between patients taking both ARV and ATM concomitantly from those using ARV alone.