HIV and Herbal Hemorrhoid Care

Please be advised that certain herbal supplements can interact with anti-HIV medications, causing the blood levels of the HIV drugs to drop below effective levels. This can lead to the development of drug-resistant HIV strains. Research is ongoing to learn more about interactions between HIV anti-viral medications and herbs. Some popular herbal supplements designed to treat hemorrhoids may contain one or more of the following ingredients. These are current documented adverse interactions:

• African potato: Widely used in Africa by people with HIV. Lab studies have shown that it competes with anti-HIV drugs in the body, because African potato is processed by the same mechanisms as HIV drugs.
• Garlic: Garlic supplements must be used with care. Studies have documented that garlic may prevent optmimal processing of protease inhibitors and NNRTIs. One study of HIV-negative persons taking a protease inhibitor found that a twice-daily garlic supplement lowered blood levels of the protease inhibitor. Garlic used for cooking is safe, however.
• St. John’s Wort (Hypericum): This popular herbal antidepressant has been shown to lower blood levels of indinavir, and potentially, all protease inhibitors and the NNRTIs efavirenz (Sustiva, also in the combination pill Atripla) and nevirapine (Viramune).
• Sutherlandia: A herb which is used in Africa for the treatment of people with HIV has been shown by laboratory studies to interact negatively with anti-HIV drugs.

Talk to your HIV doctor before choosing a vitamin or herbal supplement. She or he will be able to tell you if there is a risk of an interaction with anti-HIV drugs. Check with a dietitian to analyze your diet and advise you on the best nutritional intake so you can meet your vitamin and mineral requirements through both foods and supplements.