Are herbal medicines effective and safe in managing opportunistic infections and complications associated with Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS)' CHUKWUMA MUANYA writes.THERE have been claims and counter claims on possible herbal cures for Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS).Until now several local plants such as lemon, neem tree, garlic, scent leaf, ginger, among others have shown promise in the management of opportunistic infections associated with HIV/AIDS.However, the persistent quest for more natural products for the treatment of HIV/AIDS has uncovered a new candidate, extracts of a local plant, Baissea axillaries, which have shown promise in the treatment of diarrhoea associated with HIV/AIDS.A study published in BMC Complementary and Alternative Medicine concluded: 'Extracts of Baissea axillaries have demonstrated antimicrobial activity against clinical strains of selected microorganisms. While there is toxicity at the dose of 500 mg/kg, the therapy shows potential for application in the treatment of diarrhoea associated with AIDS/HIV. Further studies of Baissea axillaries on diarrhoea and toxicity are necessary to evaluate its mechanism of action and to fully establish its safety profile.The study is titled 'Antimicrobial and toxicological evaluation of the leaves of Baissea axillaries Hua used in the management of HIV/AIDS patients.'The University of Benin, Edo State, researchers include Tavs A. Abere of the Department of Pharmacognosy, Faculty of Pharmacy and Freddy O. Agoreyo of the Department of Anatomy, College of Medical Sciences.Baissea axillaris belongs to the plant family Apocynaceae. It is called imu in Yoruba. According to The useful plants of west tropical Africa, Vol 1 by H. M. Burkill, Baissea axillaris is a climbing shrub to three metres high of the rain forest of Southern Nigeria and Western Cameroons, and extending to Angola. The liane is used in Southern Nigeria to make palm-wine more intoxicating. A decoction of leafy twigs is taken in Congo for kidney disorders.Several studies have shown that persistent diarrhoea is a common endemic disease with high incidence among the Africans including Nigerians. It also represents a frequent opportunistic disease in people living with HIV. Diarrhoea represents one of the most distressful and persistent symptoms of HIV/AIDS, which may or may not be accompanied by an infection.According to the study, the leaves decoction of Baissea axillaries Hua (Apocynaceae) is used by traditional herbalists in Edo State, Nigeria for the management of people living with HIV/AIDS. Determination of its antimicrobial activity and toxicological profile provides supportive scientific evidence in favour of its continuous usage.Chemical and chromatographic tests were employed in phytochemical investigations. Inhibitory activities of aqueous and ethanolic extracts against clinical strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis were compared with Togamycin (Spectinomycin).'Our report includes minimum inhibitory concentration (MIC) against the test organisms. Toxicological evaluation was determined by administering 250 mg/kg and 500 mg/kg of extracts on male Wister rats for 14 days with normal saline as control. The kidneys, liver, heart and testis tissues were examined,' the researchers wrote.Phytochemical studies revealed the presence of alkaloids, tannins and cyanogenetic glycosides. The extracts inhibited the growth of Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus to varying extents, but only the ethanolic extract inhibited growth in Streptococcus faecalis.According to the researchers, the LD50 (minimum lethal dose) of the extract in mice was above 5000-mg/kg body weight when administered intra-peritoneally. Toxicological evaluation showed mere ballooning degeneration of the liver at 250 mg/kg while at 500 mg/kg there was tissue necrosis. The low and high doses showed ill-defined leydig cells in the testis and no remarkable changes in the heart and kidneys.Another study published in the International Research Journal of Biochemistry and Bioinformatics Vol. 1(5) pp. 124-130, June, 2011 noted: 'Baissea axillaries Hua, a popular herbal remedy in Nigeria used to treat many diseases was also effective in bacterial caused opportunistic infections in HIV patients. However, neem (dogonyaro) leaves that are widely distributed in Nigeria increased the CD4 count (a marker for immune function) and general well being significantly in HIV patients. '-Zam is an effective herbal remedy used by HIV patients in Nigeria as alternative or complementary therapy.'The study is titled 'Chronic toxicity profiles of '-zam, herbal concoction used for HIV infection in Nigeria' is a collaborative effort between researchers from Faculty of Health and Social Care, St. George's University of London and Kingston University, London, Osun State University, Osogbo and College of Health Sciences, Igbinedion University Okada, Edo State.The study reads: 'The effectiveness of herbal remedies in HIV infection is not doubtful. There are many herbal remedies that have been found to inhibit one or more steps in HIV replication. Alkaloids derivatives herbal remedies (example Ancistrocladus korupensis) from tropical liana plant inhibit reverse transcriptase and HIV induced cell fusion.'Pentosan poly-sulphate, a carbohydrate derivate inhibits HIV tat regulatory protein (p14) that strongly activates transcription of proviral DNA. A coumarin herbal remedy in form of canolides from tropical forest tree (Calophyllum lanigerum) was rated as non-nucleoside reverse transcriptase inhibitor in potency. Despite the fact that sero- deconversion is very rare with Highly Active Antiretroviral Therapy (HAART), some herbal remedies (example Chinese medicines) have been documented in turning HIV infected patients to sero- negativity.'There are many herbal remedies that are effective against HIV infection in Nigeria. Many of these documented herbal remedies act on the opportunistic infections caused by micro-organisms.'Another study published in Ethno-Medicine has examined the role of traditional medicine/complimentary and alternative medicines (TM/CAM) and their practitioners and products in the prevention and management of HIV/AIDS as a complementary measure to curb the spread of HIV/AIDS.The study is titled: 'Roles of Traditional Healers in the Fight Against HIV/AIDS.' The researchers include Jimoh Amzat of the Department of Sociology, Usmanu Danfodiyo University, Sokoto and Ali A. Abdullahi of the Department of Sociology, University of Ilorin, Ilorin, Kwara State.
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