The phytochemical composition, efficacy and safety of herbal formulations used for management of HIV/AIDS in Mombasa County, Kenya
Mwavita, Amos Lewa
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Kenya has the fourth largest HIV epidemic in the world with adult prevalence of 5.9% (2016) (UNAIDS). Currently 80% of HIV patients access ARVs, while the rest do not due to stigma and traditional beliefs. In the coast of Kenya some patients seek alternative treatments to manage HIV/AIDS. Pwani herbs clinic in Mombasa is a popular clinic that dispenses herbal medicines to manage HIV and AIDS. Unfortunately, these medicines have not been subjected to formal clinical research to ascertain their efficacy and safety. This study‘s objective was to isolate the components of the herbal formulations VIRAD (Antiretroviral herbal formulation) and IMB (immune boosting herbal formulation) and to determine their efficacy on immunological parameters and safety on liver and kidney parameters in the treatment for people living with HIV and AIDS (PLWHA) in Mombasa County. Herbal formulations were analyzed for phytochemical components by qualitative and quantitative screening, mineral compositions by Atomic absorption spectrophotometer (AAS) Model: 210VGP. Patients that met the inclusion criteria and for whom written/oral informed consent was obtained and were on treatment with these herbal formulations were purposely sampled as they visited the herbal clinic. Patients were evaluated for anthropometric screening including phenotypic indices, hematological, immunological parameters CD4 /CD8 and viral load tests, liver function tests, endocrine related; were screened for a period of 12 months; including HIV disease progression, quality of life and adverse side effects. Results revealed Phytochemical components (mg/100g) Virad; Phenols 84.4mg, Saponins 531mg, Tannins 324mg, Alkaloids 2304mg, Flavonoids 2173mg, Protein 442mg and Lipids 2444.2mg. Phytochemical components (mg/100g) IMB; Phenols 75.1mg, Saponins564mg, Tannins 51mg, Alkaloids 1531mg, Flavonoids 2533mg, Proteins 544mg, Lipids 2553.8mg, characterised as metabolites antioxidant, anti-inflammatory anticholinesterase, immune boosting and antiviral agents. Trace elements in VIRAD Mineral levels (μg/g) K 12922±103Na 475±4 Ca8861±71 Mg547±1 Fe361±4 Cu 98.6±1.5 Zn43.7±0.9. Trace elements in IMB Mineral levels (μg/g) K 12085±87 Na 598±11 Ca 6047±46 Mg 545±1 Fe348±4 Cu 5.9±0.4 Zn25.3±0.6. Patients with subclinical deficiencies of trace elements would be at risk of impaired immune function. A total of 188 patients were purposely recruited into this longitudinal study. They were followed every two months for a period of one year. At months 2, 4, 6, 8 and month 10, 23/188 was lost to follow-up. Out of these three 3/23 died while twenty 20/23 developed other complications such as tuberculosis and cancer. Those who developed complications were referred for specialized treatment. Others were advised to use conventional antiretroviral drugs. At baseline were two peaks for CD4 levels 300-350 and 200-250. At completion of study weight gained by average 17kg, BMI increase 4.85, CD4 raise 126, CD8 declined 15, CD4/CD8 raise 0.19, Viral load drop 864, Hemoglobin Hb raise 3g/dl, RBC raise 1.3, WBC raise 1.6, ESR drop 21. Toxicity on kidney Urea drop 0.1g/dl, Liver GGT, AST, ALT drop0.3g/dl. Flavonoids, Alkaloids and lipids were of highest concentrations in these formulations. Immunological factors CD4/CD8 were raised; viral burdens reduced therefore improved immunity and were efficacious. Liver and kidney functions were not adversely altered; these phytochemicals were not toxic and therefore safe for use.