AIDS TREATMENT NEWS #157, August 21, 1992
John S. James

(Note: For a report on how to obtain and use bitter melon send a self-addressed envelope to the AIDS Intervention Team of APLG, 300 West Sunset Blvd., Los Angeles, California 90012. Persons outside North America should include two postal reply coupons, if possible, with their request for this report.)

Another plant extract, Acemannan, from the aloe vera plant, was discussed in a published abstract. A related product was popular a few years ago, but according to the Healing Alternatives Foundation, a buyers' club in San Francisco, it has fallen out of favor. This preliminary clinical study tested Acemannan in combination with AZT and found it to be safe [PuB7488]. Unfortunately, the trial did not determine efficacy, but the average decline of T-helper cells in patients after 24 weeks of therapy was almost 40 percent, which does not look promising.

Three abstracts discussed the use of traditional African medicine in Tanzania. E. Lugakingira, a traditional African doctor, teamed up with L. Barongo, a western trained doctor, to study a traditional herbal remedy at the Traditional Medicines Unit in Nansio, Tanzania [PoB3396]. They conducted a preliminary uncontrolled clinical trial of 156 patients, and 80 percent showed clinical improvement. They say further research must be done to analyze the active agents in the compound they were using.

Similar research was conducted by David Scheinman and others from the Tanga AIDS Working Group in Tanga, Tanzania [PoB3400]. He has been studying the clinical effects of herbal remedies prepared by two traditional African healers. (Note: We plan a longer article on this project in a future AIDS TREATMENT NEWS.)

Another cooperative research program was reported from Dar es Salaam, Tanzania, where 158 patients were treated with traditional Chinese medicine [PoB3448]. The treatment used in this study was not specified, but traditional Chinese medicine usually employs a variety of herbs in specific combinations and usually includes acupuncture treatments. Approximately half of the patients reportedly had a decrease in symptoms such as fatigue, diarrhea, and wasting.

The Community Research Initiative of New England, in Boston, conducted an observational clinical study on the use of acupuncture for the treatment of peripheral neuropathy not due to drug toxicity [PuB7554]. The trial showed that patients generally had a positive benefit or no change; important findings considering that the standard of care for peripheral neuropathy is often ineffective. In another paper on acupuncture, presenting anecdotal research findings, Magnolia Goh from the Gay Men's Health Crisis in New York describes decreased symptoms, decreased rate of opportunistic infections, and weight gain in most of her patients [PoB3393]. The same author published an abstract on a Chinese herbal tea remedy [PoB3441].

The importance of exercise and body movement therapy such as yoga, dance and relaxation techniques was described in two papers. Adelheid Rehse from the Pella VIDDA Group in Rio de Janeiro, Brazil [PuB7464] suggested that these forms of therapy helped improve patients' confidence in their bodies. A controlled, randomized clinical trial of exercise was conducted by Celia Schlenzig at the University of Heidelberg, Heidelberg, Germany [PoB3401]. Patients in the exercise group had more stable T-helper cells and slower disease progression then patients in the control group.

Prevalence of Alternative Therapies

There were numerous papers reviewing the usage of alternative treatments in different communities around the world [for example, PuB7491, PuB7517, PoB3402, PoB3398, PoB3395, and oral presentation ThB1508] in addition to those reviewed below.

The use of alternative medicines by women was specifically addressed by Imani Harrington of San Francisco with the help of a survey created by the Center for Natural and Traditional Medicines in Washington D. C. [PuB7233]. The researchers reported that all of the 50 HIV-positive women they interviewed were engaging in some form of alternative or self-care activity, with women using many alternative treatments for women-specific health problems that are not adequately addressed by western allopathic medicine.

The factors that determine the choice of traditional medicine versus western allopathic medicine by HIV-positive African women were studied by Rachel King from the Projet San Francisco in Kugali, Rwanda [PoB3394]. She found that the majority of the women are using both forms of health care. The women look to traditional medicine for treating symptoms such as weight loss, weakness, nausea, and dermatitis (including herpes zoster). Western medicine was sought for exploratory medical tests and for illnesses that were perceived to be internal.

David Baker and Richard Copeland of San Francisco identified the most popular alternative treatments being employed by HIV- positive gay men and commented on the importance of looking to people with HIV and AIDS for leads in the development of new treatments. Some of the treatments they identified as being popular were vitamin C, NAC, DNCB (dinitrochlorobenzene), Compound Q, Chinese herbs, and Iscador (mistletoe extract) [PoB3391].

A self-help manual for prisoners with HIV or AIDS was presented by Stephen Korsia of the AIDS Project Los Angeles [PoB3378]. He discussed treatments they can do for themselves in prison including such things as self-massage, acupressure, nutritional supplementation, and visualization/meditation.

Comment

Politically, this year marked a change in the course of the conference toward greater attention to alternative or traditional treatments, in addition to mainstream pharmaceutical industry drugs. As time passes and the limitations of western medicine become more defined, it is increasingly important for there to be cooperation among different medical traditions.

In general, this year's conference seemed to be more inclusive of ideas and people that have been left out in the past, and we can only hope that this is a trend that will increase in coming years. At a meeting in Amsterdam with activists, Peter Piot, the incoming president of the International AIDS Society (which is the formal sponsor of the International Conference), agreed on the fundamental importance of alternative treatments. He stated that he believes that 90 percent of people with HIV or AIDS in Europe are using some form of alternative treatment. Dr. Piot met with the organizers of the 1993 conference in Berlin and persuaded them to include alternative and traditional medicines in the scientific tracks that already exist. What they have not yet agreed to is the creation of an abstract review board specific to these treatments, to insure fairness in the abstract approval process by delegating the job to experts in this field.

(Note: AIDS TREATMENT NEWS usually includes degrees -- e.g. "M. D. " -- the first time names are used in an article. We will not do so in covering the International Conference because degrees are not included in the conference documentation, and it would be difficult or impossible to contact all the authors in time for publication.)

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