Interactions between antiretroviral therapy and complementary and alternative medicine: a narrative review

Abstract

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Biological properties and therapeutic applications of garlic and its components

“…51 However, numerous studies indicate that supplementation with garlic or its derivatives could exert an undesirable interaction with prescribed antiretroviral drugs against HIV disease. 52,53…”

Nutraceuticals in HIV and COVID-19-Related Neurological Complications: Opportunity to Use Extracellular Vesicles as Drug Delivery Modality

“…However, there is no positive correlation between the supplementation of vitamin C and a reduction in oxidative stress [ 82 , 83 ]. It has also been suggested that daily use of 1000 mg of vitamin C for 7 days appears to induce certain hepatic cytochromes, including cytochrome P450 3As (CYP3As), which leads to a decrease in the Cmax of indinavir by 20% [ 84 ]. More studies and trials are needed to draw a conclusion on the benefits of vitamin C on disease progression and prognosis of HIV infection.…”

“…Ginkgolic acid (GA) produced by GB can act as an inhibitor against HIV and other enveloped viruses through the inhibition of protease activity [ 86 , 87 ]. GA is also widely used as a natural therapeutic agent to improve memory and treat conditions such as hemorrhoids, dementia, and depression [ 84 ].…”

“…However, several studies have shown that the terpene-containing GA may induce CYP3A4 and P-gp, leading to an increase in viral loads from undetectable to detectable levels of 1350 copies/mL in HIV/AIDS patients who are treated with efavirenz. Thus, drug interactions must be taken into consideration, and the concurrent use of GA and efavirenz is generally not recommended [ 84 ].…”

Suspected adverse reactions to performance enhancing dietary supplements: Spontaneous reports from the Italian phytovigilance system

“…The causality evaluation is further complicated when the suspected adverse reactions are associated with multicomponent products. Moreover, people often use dietary supplements along with conventional drugs, with the potential risk of pharmacological interactions (Bordes et al, 2020;Chrubasik-Hausmann, Vlachojannis, & McLachlan, 2019). At last, the possible presence of undeclared ingredients, or quality issues, could increase the safety concerns (Ekar & Kreft, 2019).…”