e-ISSN: 2448-8062
ISSN: 0188-431X
Resumen
Introducción: una alternativa para mitigar los efectos del virus de inmunodeficiencia humana (VIH) es la medicina complementaria, alternativa o integrativa (MCAI); sin embargo, esta puede tener una influencia negativa en los pacientes con VIH.
Objetivo: estimar la relación entre la carga viral y el uso de MCAI en pacientes con VIH/SIDA.
Metodología: estudio analítico con 232 pacientes de la clínica de VIH/SIDA de una unidad médica de segundo nivel de atención en Cancún, México. Previo consentimiento informado, a cada paciente se le aplicó un cuestionario para identificar el uso de la MCAI y simultáneamente se obtuvo el conteo de carga viral y el CD4 del expediente electrónico.
Resultados: el 47.8% utilizaron herbolaria como tratamiento alternativo. No se encontró diferencia estadística entre la utilización de herbolaria y su conteo de carga viral (p > 0.646). La terapia cuerpo-mente, los suplementos vitamínicos, la homeopatía y la acupuntura se usaron del 5 al 24.6%, sin diferencia estadística (p > 0.05) entre los grupos. Por el contrario, el uso de sesiones de manipulación del cuerpo mostró diferencia en relación con quienes no las utilizaban (p < 0.05).
Conclusiones: es importante que el profesional de la salud identifique los efectos adversos o benéficos de las terapias alternativas y complementarias, con la finalidad de orientar a sus pacientes y no afectar su tratamiento antirretroviral y, en consecuencia, su conteo de carga viral.
Abstract
Introduction: An alternative to mitigate the effects of human immunodeficiency virus (HIV) is the complementary and alternative medicine (CAM); however, this could have a negative influence in patients with HIV.
Objective: To estimate the relationship between viral load and the use of CAM in patients with HIV/AIDS.
Method: Analytical study with 232 patients from the HIV/AIDS Clinic of a second-level healthcare unit in Cancun, Mexico. With prior informed consent, a questionnaire was administered to each patient to identify the use of CAM, and, simultaneously, the viral load and CD4 counts were obtained from their electronic file.
Results: 47.8% used herbal medicine as an alternative treatment. No statistical difference was found between the use of herbal products and their viral load (p > 0.646). Body-mind therapy, vitamin supplements, homeopathy and acupuncture were used from 5 to 24.6% without statistical difference (p > 0.05) among groups. However, the use of massage therapy showed a difference in relation to those who did not use it (p < 0.05).
Conclusions: It is important that health professionals identify the adverse or beneficial effects of alternative and complementary therapies, so that they can guide their patients and not affect their antiretroviral treatment and, consequently, their viral load.
Carnicer-Pont D, Vives N, Casabona-I Barbarà J. Epidemiología de la infección por virus de la inmunodeficiencia humana. Retraso en el diagnóstico. Enferm Infecc Microbiol Clin. 2011;29(2):144-51.
UNAIDS. Últimas estadísticas sobre la epidemia de SIDA. UNAIDS; 2019. Disponible en https://www.unaids.org/es/resources/factsheet [consultado el 27 de mayo de 2021].
Iribarren JA, Labarga P, Rubio R, Berenguer J, Miró JM, Antela A et al.; Grupo de Estudio de Sida (GESIDA) y Consejo Asesor Clínico (CAC) del Plan Nacional sobre el SIDA del Ministerio de Sanidad y Consumo (España). Recomendaciones de Gesida/Plan Nacional sobre el SIDA respecto al tratamiento antirretroviral en adultos infectados por el virus de la inmunodeficiencia humana. Disponible en https://gesida-seimc.org/wp-content/uploads/2017/02/DcyRc _Recomendaciones-TAR-GESIDA-PNS.pdf.
Izzo A. Herb-drug interactions: an overview of the clinical evidence. Fundamental Clinical Pharmacology. 2004;19:1-16.
National Center for Complementary and Integrative Health. Complementary, Alternative or Integrative Health: What´s in a Name? Disponible en https://nccih.nih.gov/health/integrativehealth#cvsa.
Duggan J, William S, Schutz M, Khuder S, Charkraborty J. Use of complementary therapies and characteristics of users among HIV-infected people. Int J STD AIDS. 2003;14(7):482-6.
Nlooto M. Views and experiences of healthcare professionals towards the use of African traditional, complementary and alternative medicines among patients with HIV infection: the case of eThekwini health district, South Africa. BMC Complement Altern Med. 2015;15:170.
Endres HG, Molsberger A, Lungenhausen M, Trampisch HJ. An internal standard for verifying the accuracy of serious adverse event reporting: the example of an acupuncture study of 190,924 patients. Eur J Med Res. 2004;22;9(12):545-51.
Klougart N, Leboeuf-Yde C, Rasmussen LR. Safety in chiropractic practice, Part I; The occurrence of cerebrovascular accidents after manipulation to the neck in Denmark from 1978-1988. J Manipulative Physiol Ther. 1996;19(6):371-7.
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary Referencias and alternative medicine use among adults: United States, 2002. Semin Integr Med 2004;2(2):54-71.
Littlewood RA, Vanable PA. A global perspective on complementary and alternative medicine use among people living with HIV/AIDS in the era of antiretroviral treatment. Curr HIV/AIDS Rep. 2011 8(4): 257-68.
Lorenc A, Robinson N. A review of the use of complementary and alternative medicine and HIV: Issues for patient care. AIDS PATIENT CARE and STDs. 2013;27(9):503-10.
Abou-Rizk J, Alameddine M, Naja F. Prevalence and characteristics of CAM use among people living with HIV and AIDS in Lebanon: Implications for patient care. Evidence-Based Complementary Alternative Medicine eCAM. 2016(2016):5013132. PMC.
Herrera-Arellano A, Jaime-Delgado M, Herrera-Álvarez S, Oaxaca-Navarro J, Salazar-Martínez E. Uso de terapia alternativa/ complementaria en pacientes seropositivos a VIH. Rev Med Inst Mex Seguro Soc 2009;47(6):651-8.
Agnoletto V, Chiaffarino F, Nasta P, Rossi R, Parazzini F. Reasons for complementary therapies and characteristics of users among HIV infected people. International Journal of STD & AIDS 2003; 14(7):482-6.
Burg MA, Uphold CR, Findley K, Reid K. Complementary and alternative medicine use among HIV-infected patients attending three outpatient clinics in the Southeastern United States. International Journal of STD & AIDS 2005;16(2):112-6.
Colebunders R, Dreezen C, Florence E, Pelgrom Y, Schrooten W. The use of complementary and alternative medicine by persons with HIV infection in Europe. Int J STD AIDS. 2003;14(10):672-4.
Mikhail IS, Di Clemente R, Person S, Davies S, Elliott E, Wingood G, et al. Association of complementary and alternative medicines with HIV clinical disease among a cohort of women living with HIV/ AIDS. J Acquir Immune Defic Syndr. 2004;37(3):1415-22.
Tsao JC, Dobalian A, Myers CD, Zeltzer LK. Pain and use of complementary and alternative medicine in a national sample of persons living with HIV. Jornal of Pain and Symptom Management. 2005;30(5):418-32.
Kirksey KM, Goodroad BK, Kemppainen JK, Holzemer WL, Bunch EH, Corless IB, et al. Complementary therapy use in persons with HIV/AIDS. J Holist Nurs. 2002;20(3):264-78.
Vázquez-Hernández M, Hurtado-Gómez MF, Blanco JR. [The influence of alternative medicine in highly active antiretroviral treatment]. Farm Hosp. 2009;33(1):31-6.
Mills E, Montori V, Perri D, Phillips E, Koren G. Natural health product-HIV drug interactions: a systematic review. Int J STD AIDS. 2005;16(3):181-6.
Hsiao A, Wong M, Kanouse D, Collins R, Liu H, Andersen R, et al. Use and Substitution for Conventional Therapy but HIV-Infected Patients. J AIDS. 2003; 33(2):157-165.