Clinical Trials and Observational Studies

One small observational study by Qingcai Zhang of the Sino
Medical Institute of New York on the use of extract of bitter
melon, Momordica charantia, showed a marked increase in T- helper
cells [PuB7597]. The patient who had the largest increase went
from 480 T-helper cells to 1370 after treatment for three years.
The patient with the smallest increase went from 336 T-helpers
cells to 446 over a period of eleven months. The data was only
collected from six patients and the study was not controlled or
blinded, so it is hard to draw conclusions about this treatment.
As the use of bitter melon grows in the community we will be
watching closely to find out more about its efficacy and
usefulness.

(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.)