Alternative medicine

The use of complementary alternative medicine in HIV-infected patients during the COVID-19 pandemic: its related factors and drug interactions with antiretroviral therapy

This article was originally published here

Acta Med Indonesia. 2022 Jan;54(1):97-106.


BACKGROUND: The use of complementary and alternative medicine (CAM) is widespread among patients with chronic conditions despite the lack of supporting evidence for most types of CAM. Concern about the higher risk of COVID-19 for HIV-infected patients will likely increase the use of CAMs during the COVID-19 pandemic in this population. This study aimed to assess the prevalence and factors related to the use of CAMs in HIV-infected patients during the COVID-19 pandemic, and then to identify the drug-drug interaction (DDI) of antiretroviral (ARV) drugs with the CAM they used.

METHODS: The study was conducted at HIV Clinic Cipto Mangunkusumo in September-October 2021, specifically targeting adult HIV-infected patients using ARVs regularly. Demographic and clinical data, including COVID-19 and vaccination history, were drawn from clinical survey and hospital medical record data.

RESULTS: 554 of 1275 patients (43.5%) reported using any type of ingested CAM during the COVID-19 pandemic, primarily 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 duration of ART of 2-5 years compared to over 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 other interactions were classified as unknown. Only a limited number of patients (3.8%) were aware of the drug interaction between the ARVs and the CAMs they were using.

CONCLUSION: CAMs were commonly used by HIV-infected patients on ARVs during the COVID-19 pandemics, but patient awareness of CAM-ARV drug interactions was extremely low.