The Influence Of Herb Medicine Of HIV On HIV Resistance And Efficacy Of HAART

With the widely spreading of HAART, new problems and research progress are ermerged. At the same time, the pratice and mechanisim of Herb medicine to treat AIDS is developing. Neither HAART nor Herb alone is able to cure HIV/AIDS. Combination of HAART and Herb medicine has become an important treatment stratage, while it also arouse new discussions. Among these, whether Herb medicine affects HAART’s effect is worth to be explored.This research aim to explore interaction between HAART and Herb medicne, datas are from retrospective clinical comparison, HAART pharmacokinetic on rats, liver toxicites and concentration of AZTObjective1、To compare HAART efficacy, HIV resistance, side effects, complications between herb medicine+ HAART and HAART alone and analyze Herb medicne increases these markers or not;2、To explore impact of Ai Ke Qing power on the pharmacokinetic of HAAR medicne AZT,3TC, EFV;3、To explore whether the effect of Ai ke Qing powder on AZT, will lead to worse AZT-induced liver toxicity, and the relationship between AZT concentration and liver toxicities.Methods1、Retrospective collecting datas of those initiating HAART for more than 12 monthes. Patients were divided into two groups:HAART+Herb medicine group;HAART group. Datas include gender, age, HIV trasmission mode, basic CD4+T count, viral load,side effects et al. To analyze correlation of group difference and HAART efficacy, including HIV viral load, increased CD4+T count, HAART’s side effect and complications. Using SPSS data analysis tool, P<0.05 is defining statistic difference.2、SD rats are divided into two groups:group 1 with oral HAART+ Ai Ke Qing, group 2 with oral HAART alone,12 rats in each group. After one dose medicine, blood is taken on time 0,0.5、1、2、3、4、6、8、10、12h. To detect concentration of AZT、3TC、EFV wih HPLC-MS method。 Pharmacokinetic parameters are caculated with software DAS 2.0, dada analysis with SPSS 16.0.3、SD rats are divided into four groups, each group has 4 rats:group 1:AZT alone;group 2:AZT+ Ai Ke Qing;group 3:AZT+3 times dose’s Ai Ke Qing;group 4:no medicine.After feeding 15 days to detect AZT plasma and intracellular concentration,and do liver biopsy for HE pathology.Results1、Data of 241 cases are collected, among this 84 are HAART+herb medicine, 157 are HAART alone.Two groups has comparable ratio of gender, age, transmitted mode, basic CD4+T count.On treatment 12 month, increased CD4+T count are 165±136/u1、173±144/u1; (P>0.05);viral load failure are 2 (2.3%).1 (0.6%);detecting viral load (>20copies/ml) are 8 (9.5%)、22 (14%); side effects are 5 (5.9%)、10 (6.3%); complications are 2 (2.3%)、0 (0%); co-morbidity are 1 (1.1%)、3 (1.9%), respectively, all P >0.05; age older≥50y is a risk factor affecting CD4+T increase, while basic CD4+T count≤200/ul is an independent fator on inhibiting HIV viral;adherence is a key issue on viral failure2、Three linearity of concentration are:AZT:y= 0.1286 x-0.0430 (R2=0. 0.9996); 3TC:y= 0.027 x-0.001 (R2=0.9989); 3) EFV:y= 0.1136 x-0.1092 (R2=0.9973), Ai Ke Qing +HAART doesn’t affect pharmaco parameters of AZT,3TC,EFV,but group with Ai Ke Qing has higher Cmax of AZT,3TC. Mean difference has statistic difference (P>0.05).3、Group AZT has one rat die on day 8th. Rats in high dose Ai Ke Qing are more active, more intake and gain more weight. Concentration of group without medicine is zero. Two groups on Ai Ke Qing have lower AZT concentration compared with group on AZT alone (P<0.05),but higher dose Ai Ke Qing has no difference plasma AZT concentration with group of normal Ai Ke Qing, but Ai Ke Qing group has lower intracellular AZT concentration compared with higher doze group.Pathology of liver biopsy shows Ai Ke Qing group has less cell inflammatory cell infiltration and flat-face cells than high dose group and AZT alone group.Conculsion1、Herb medicine has no influence on HIV resistance after 12 month’s HAART,also has no influence on side effect,complications and co-morbidity.Initial HAART in late AIDS affect HIV viral inhibiting. Adherence is a key issue and 2 of 3 viral failure are due to poor adherence2、Combining Ai Ke Qing with HAART doesn’t affect group pharmacokinetic of EFV, AZT,3TC in HAART combination, but more rats has higher AZT Cmax on Ai Ke Qing group.3、After a duration of AZT,Group 2 Ai Ke Qing +HAART has lower liver toxicites, together with lower intracellular AZT, prediting that more AZT are transfered into AZT-TP to kill HIV, and lower plasma AZT is protected on liver toxicity.