Santé
Plantes médicinales et traitement du sida

En mai 1999, à l’occasion d’un colloque consacré aux 10 ans de la recherche sur le sida en Suisse, une série de travaux inédits étaient présentés (sur ce colloque, voir l’article dans Le Temps du 25 mai 1999). Parmi ceux-ci, une étude abordait le thème du traitement du sida au moyen de plantes médicinales chinoises et concluait à son inefficacité dans des conditions médicales occidentales.

Pour en savoir un peu plus, voici un résumé de l’article que l’équipe du Dr Rainer Weber, Département de médecine interne de l’Hôpital universitaire de Zurich, Division des maladies infectieuses et de l’hygiène hospitalière, vient de faire paraître.
Nos remerciements au Dr Weber de nous avoir transmis ce résumé.

Weber R, Christen L, Loy M, Schaller S, Christen S, Joyce CR, Ledermann U, Ledergerber B, Cone R, Luthy R, Cohen MR. Randomized, placebo-controlled trial of Chinese herb therapy for HIV-1-infected individuals. J Acquir Immune Defic Syndr 1999 Sep 1;22(1):56-64 Department of Internal Medicine, University Hospital, Zurich, Switzerland.

Abstract

CONTEXT: Alternative medicine or complementary remedies that have not been scientifically tested are nonetheless widely used to treat chronic illnesses, particularly if curative options are limited. OBJECTIVES: To assess the effectiveness of Chinese medicinal herbs in reducing symptoms and improving the quality of life of HIV-infected persons. DESIGN: Prospective, placebo-controlled double-blind study.

SETTING: University-based HIV outpatient clinic.

PATIENTS: 68
HIV-infected adults with CD4 cell counts <0.5 x 10(9)/L.

INTERVENTION: Participants were randomized to receive four daily doses of seven pills containing a standardized preparation of 35 Chinese herbs or placebo for 6 months.
MAIN OUTCOME MEASURES: Symptoms, HIV disease progression, HIV-1 RNA plasma viral loads, CD4 and CD8 cell counts, and scores on standard questionnaires for quality of life, depression, anxiety, and coping. RESULTS: Intervention and placebo groups were equivalent at baseline regarding, respectively, previous antiretroviral therapy (74% versus 79%), median CD4 cell counts (0.20 x 10(9)/L versus 0.25 x 10(9)/L), and median HIV-1 plasma viral loads (35,612 copies/ml versus 52,027 copies/ml). At enrollment, none of the study subjects was seriously ill or depressed, and average coping and quality of life scores were in the normal range. In all, 53 (78%) participants completed the study. Patients taking Chinese herbs reported significantly more gastrointestinal disturbances (79% versus 38%; p = .003) than those receiving placebo. No therapy-related toxicities were observed. At completion of the study, no significant differences between the intervention and placebo groups were found regarding plasma viral loads, CD4 cell counts, symptoms, and psychometric parameters. HIV-1 RNA level was unchanged at study end. Among participants who were not on concomitant antiretroviral therapy, median CD4 cell counts declined by 0.05 x 10(9)/L in both the intervention and placebo groups.

CONCLUSIONS:
This standardized formulation of Chinese herbs for HIV-infected individuals did not improve quality of life, clinical manifestations, plasma virus loads, or CD4 cell counts. The data suggest that this formulation of Chinese herbs is not effective when administered in a Western medicine setting.