The Use of Complementary Alternative Medicine in HIV-infected Patients during COVID-19 Pandemic: Its Related Factors and Drug Interactions with Antiretroviral Therapy

Evy Yunihastuti, Teguh Harjono Karjadi, Nafrialdi Nafrialdi, Indah Mediana, Salma Sundari, Andrian Wiraguna, Aljira Fitya Hapsari, Amalia Irsha Adhari, Aulia N. S. Putri Khumaini, Tiara Kumala Putri


Background: The use of complementary and alternative medicine (CAM) is widespread among patients with chronic disease despite lack of supporting evidence for most CAM types. Concerned regarding higher risk of COVID-19 for HIV-infected patients, probably increase the use of CAM during COVID-19 pandemic in this population. This study aimed to assess the prevalence and factors related to CAM use among HIV-infected patients during COVID-19 pandemic, then identify drug- to-drug interaction (DDI) of antiretroviral (ARV) drugs with CAM that they used. Methods: The study was conducted in HIV Clinic Cipto Mangunkusumo Hospital in September-October 2021, specifically targeting adults HIV-infected patients routinely using ARV. Demographic and clinical data, including COVID-19 and vaccine history, were taken from clinic survey and hospital medical records data. Results: 554 of 1275 patients (43.5%) reported using any type of ingested CAM during COVID-19 pandemic, mostly vitamins and/or minerals. Factors related to CAM use were history of COVID-19 infection (aOR 2.28; 95% CI 1.65-3.14) and 2-5 years ARV duration compared to more than 10 years (aOR 1.4; 95% CI 1.02–1.91). Five known potential interactions involving 20 patients and two potential weak interactions involving 8 patients were found, but many of other interactions categorized as unknown. Only limited number of patients (3.8%) were aware about the drug interaction between ARV and CAM that they used. Conclusion: CAM was commonly used by HIV-infected patients on ARV during the COVID-19 pandemics, but patient awareness related to CAM-ARV drug interactions was exteremely low.


complementary therapies; HIV; COVID-19; herbal; drug interactions


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