Interaction of Traditional Remedies Against HIV, Nutrients and ARVs

South Africa is home to the world’s largest population of people living with HIV/AIDs (5.7 million) and Sub-Saharan Africa is heavily affected with 22.4 million people living with the disease. Access to highly active antiretroviral (ARV) drugs is limited and many patients even when they are on ARVs consult traditional healers for herbal remedies. These traditional remedies as well as natural health products are widely used by HIV-infected patients in Southern Africa and other parts of the world. The limitations and uncertainties surrounding the effectiveness of ARVs in the treatment of HIV/AIDS have created a continuing search for new data on the possible drug-drug and drug-nutrient interactions. In this regard advances in the study of cytochrome P450, the enzyme system most commonly involved in drug metabolism, has provided mechanisms to investigate interactions of ARVs with natural health products and with nutrients in foods. This chapter reviews some of the possible effects of certain foods of plant origin, including dietary supplements of herbal and botanical origin, indigenous foods and traditional medicines on the regulation of CYP450 enzyme activities, focusing on their possible interaction with ARV drugs. It also discusses future considerations surrounding the improvement of HIV/AIDS treatment management aiming at reducing resistance to ARV drugs and increase awareness of potential food-drug interactions that can render ARV treatment ineffective.