Traditional Herbal Medicine Use Associated with Liver Fibrosis in Rural Rakai, Uganda
Abstract
Traditional herbal medicines are commonly used for HIV/ AIDS and other health conditions in Uganda and sub-Saharan Africa, often in parallel with programs that provide antiretroviral therapy (ART). In the 1990's an estimated 80% of Ugandans living in rural villages used traditional healers for primary health care [1]. A study of 137 HIV-infected Ugandans receiving ART found that 60% used herbs concurrently with ART [2]. In Uganda traditional herbal medicines are usually boiled extracts of herbs taken orally [3]. Some potentially hepatotoxic traditional herbal medicines used in Uganda and sub-Saharan Africa include Hoodia gordoni [4], kava [5], Phytolacca dioica [6], and herbs from the Asteraceae family [7]. Little is known about the hepatotoxicity of other commonly used herbs or the contribution of herbs to the burden of liver fibrosis and hepatocellular carcinoma in sub- Saharan Africa, including when used concomitantly with ART. Data on the specific types of herbs taken by HIV-infected persons in Uganda is limited, as is information about their components, side effects, toxicities, and ART interactions [8]. In Rakai, Uganda, liver toxicity associated with herbal medicine may be of particular concern given the high prevalence of significant liver disease (17%) among HIV-infected persons in Rakai recently identified by transient elastography (FibroScanH Echosense, Paris, France) [9]. In the aforementioned study reported herbal medicine use was associated with a two-fold increased risk of significant liver disease, defined as a transient elastography score equivalent to METAVIR liver fibrosis stage 2 (portal fibrosis with few septa) or greater [9]. The study presented here follows up on this prior investigation with an in-depth analysis of the herbs used by study participants and their relation to liver fibrosis.
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 27, 2012
- Accession Number
- ADA570693
Entities
People
- Aggrey S. Semeere
- Anthony Ndyanabo
- Brandon J. Auerbach
- Collins Kukunda-byobona
- Concepta Merry
- David L. Thomas
- Fred Nalugoda
- Gregory D. Kirk
- Iga Boaz
- Lara Stabinski
- Maria J. Wawer
- Mohammed Lamorde
- Ponsiano Ocama
- Ron H. Gray
- Steven J. Reynolds
- Thomas C. Quinn
- Valerian Kiggundo
Organizations
- Harvard Medical School