Echinacea and AIDS

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EchinaceaUpdated: Aug 01, 2003 Echinacea is a herb of North American origin

first used by native Americans to treat colds, coughs, flu, skin complaints,

toothache and even snake bites.

 

Echinacea was subsequently adopted by herbal practitioners who learnt of its

value from native Americans, and it became a commonly used herbal medicine in

Germany where much research has been conducted into the effects of the plant.

 

Two species of echinacea are commonly used for medicinal purposes: echinacea

purpurea and echinacea angustifolia.

 

Echinacea is a potent immune stimulator and may also have anti-viral properties.

These properties cannot be isolated from an individual chemical constituent of

the plant, but seem to act in combination in extracts of the whole plant.

 

Unfortunately much of the research on echinacea has been conducted using

purified forms of the plant extract rather than the powdered or diluted forms

commonly available through health food stores. Any differences in strength or

effectiveness are unknown.

 

Echinacea in people with HIV

Echinacea has not been tested as an anti-HIV compound, but may have anti-viral

properties. Cells treated with echinacea extract have been shown to resist

subsequent infection when a virus is introduced into the cell culture. Echinacea

did not prevent viral replication when it was added to cell cultures already

infected.

 

Laboratory studies using a purified extract of echinacea have shown that it

stimulates macrophages to release immune system messengers (e.g. tumour necrosis

factor (TNF), interleukin-1 and beta-interferon). Whether this form of immune

stimulation is beneficial in HIV-positive people is a matter of debate. In

people with already elevated levels of TNF-alpha and beta-interferon, further

immune stimulation may be counter-productive. Some herbalists do not prescribe

echinacea to HIV-positive people with CD4 counts below 200.

 

It is often suggested by herbalists that for echinacea to be an effective immune

stimulant, it should not be used daily. Many practitioners will recommend

periods of abstinence of perhaps ten days a month. A 1989 study by the US

National Cancer Institute suggests that daily use of echinacea may suppress the

immune response (Luettig). Other studies using very high doses have drawn

similar conclusions. At present there is no hard evidence either that echinacea

is a beneficial immune stimulant in HIV-positive people, or that it has harmful

effects on immunity, but these findings indicate that it should be used with

care, in consultation with an experienced herbalist whilst undergoing regular

monitoring.

 

A trial of a herbal combination called KM1 (a fluid containing echinacea, St

John's Wort, eleuthrococcus and astragalus) as an immune-modulating therapy for

HIV-positive people with CD4 counts below 400, was being conducted in Australia

in the 1990s but results of this study have never been published.

 

Echinacea to treat thrush

Echinacea has been shown to reduce the recurrence of vaginal yeast infections

such as Candida. In a study comparing those who had been randomized to received

echinacea in oral tablet form as a supplement to a standard vaginal anti-fungal

cream with those who received only standard treatment, only 16% of the echinacea

group experienced a recurrence within 6 months, compared with 60% of the

standard treatment group. It should be noted that this study was not conducted

in HIV-positive women and looked at localised anti-fungal treatment rather than

the systemic anti-fungals commonly prescribed to HIV-positive individuals.

 

Echinacea to treat other infections

The Chelsea and Westminster Hospital in London conducted two trials of

echinacea. The first was a placebo-controlled trial that tested echinacea as a

treatment for genital herpes among HIV-negative people. Over one year, 50

patients received six months treatment with placebo and six months treatment

with Echinaforce. There was no statistically significant benefit associated with

echinacea (Vonau 2001). The second trial, examining the effectiveness of

echinacea cream in the treatment of a bacterial skin infection called

folliculitis among people with HIV, has not been published.

 

There is some evidence that echinacea can reduce the severity and duration of

symptoms of the common cold (Schulten) and improve the body's immune response to

a cold (Kim). However, there is conflicting evidence, with a recent

placebo-controlled study reporting that echinacea had no impact on the duration

or severity of cold symptoms (Barrett).

 

Side effects

Adverse reactions to echinacea are few and far between, according to herbalists,

although application of strong tinctures of echinacea to the skin sometimes

causes irritation. This can be avoided by diluting the tincture. Allergic

reactions, rash and asthma attacks have been reported in people starting

echinacea (Mullins).

 

References

 

Barrett BP et al. Treatment of the common cold with unrefined echinacea. A

randomized, double-blind, placebo-controlled trial. Annals of Internal Medicine

137(12):939-946, 2002.

 

Foster S. Echinacea: Nature's Immune Enhancer (Healing Arts Press, Vermont, USA,

1990).

 

Kim LS et al. Immunological activity of larch arabinogalactan and Echinacea: a

preliminary, randomized, double-blind, placebo-controlled trial. Alternative

Medicine Review 7(2):138-149, 2002.

 

Luettig B et al. Macrophage activation by the polysaccharide arabinogalactan

isolated from plant cell cultures of Echinacea purpurea. Journal of the NCI

81(9):669-675, 1989.

 

Mullins RJ et al. Adverse reactions associated with echinacea: the Australian

experience. Annals of Allergy Asthma Immunology 88(1):42-51, 2002.

 

Schulten B et al. Efficacy of Echinacea purpurea in patients with a common cold.

A placebo-controlled, randomised, double-blind clinical trial.

Arzneimittelforschung 51(7):563-568, 2001.

 

Vonau B et al. Does the extract of the plant Echinacea purpurea influence the

clinical course of recurrent genital herpes? International Journal of STDs and

AIDS 12(3):154-158.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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