Impact of African herbal medicines on antiretroviral metabolism
Dept. Clin. Epidemiol. Biostatist., McMaster University, Hamilton, Ont., Canada; University of British Columbia, BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Division of Infectious Diseases, Ottawa General Hospital, Ottawa, Ont., Canada; Department of Medicine, University of Toronto, Toronto, Ont., Canada; Can. Coll. of Naturopathic Medicine, Toronto, Ont., Canada; Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
We examined the effects of two African herbal medicines recommended for HIV/AIDS patients on antiretroviral metabolism. Extracts from Hypoxis and Sutherlandia showed significant effects on cytochrome P450 3A4 metabolism and activated the pregnane X receptor approximately twofold. P-glycoprotein expression was inhibited, with Hypoxis showing 42-51% and Sutherlandia showing 19-31% of activity compared with verapamil. Initiating policies to provide herbal medicines with antiretroviral agents may put patients at risk of treatment failure, viral resistance or drug toxicity.
antiretrovirus agent; cytochrome P450 3A4; glycoprotein P; Hypoxis hemerocallidea extract; nelfinavir; plant extract; pregnane X receptor; rifampicin; Sutherlandia extract; unclassified drug; verapamil; acquired immune deficiency syndrome; article; controlled study; drug metabolism; drug toxicity; enzyme activation; human; human cell; Human immunodeficiency virus infection; Hypoxis; priority journal; protein expression; treatment failure; virus resistance; Anti-Retroviral Agents; Aryl Hydrocarbon Hydroxylases; Cytochrome P-450 CYP3A; Fabaceae; Herb-Drug Interactions; Humans; Hypoxis; Oxidoreductases, N-Demethylating; P-Glycoprotein; Phytotherapy; Plant Extracts; Receptors, Cytoplasmic and Nuclear; Receptors, Steroid; Verapamil