Milk
Thistle Compound Silymarin Safe and Potentially Effective for HIV-HCV Coinfected
Patients on HAART
By
Liz Highleyman  | Milk
thistle plant (Silybum marianum). |
Given
the limited effectiveness and difficult side effects of interferon-based
therapy for chronic hepatitis C virus (HCV)
infection, investigators have explored various alternative and complementary
therapies to help slow the progression of liver disease. Among these is silymarin,
a component of the milk thistle plant (Silybum marianum). In
a poster presented at the XVII International AIDS Conference
this month in Mexico City, George Carter of the Foundation for Integrative AIDS
Research and colleagues described a study of silymarin in HIV-HCV
coinfected individuals.
In this double-blind trial, 21 coinfected participants
were randomly assigned to receive either an 80% standardized silymarin extract
(180 mg 3 times daily) or placebo for 52 weeks. The patients were divided roughly
evenly between men and women, with about half African-American and half Latino.
Demographic characteristics of the 2 arms were similar.
Results
•
Retention was
good overall, with 15 participants completing the study (7 in the silymarin arm,
8 in the placebo arm).
•
No beneficial
or adverse effects on CD4 cell count, HIV RNA, or HCV RNA levels were observed
in either arm.
•
Milk thistle's
lack of effect on HIV viral load suggests it did not interact with antiretroviral
drugs.
•
There was a
slight decrease of 8.4 IU/L in aspartate aminotransferase (AST) in the milk thistle
arm, compared with an increase of 27.9 IU/L in the placebo arm (P = 0.099)
•
There were
no serious adverse events in either arm.
•
No significant
hematological laboratory abnormalities were noted.
•
There were
no significant differences in quality of life parameters in the 2 arms.
Based
on these findings, the researchers concluded, "Milk thistle was safe in this
study population, with no clinically significant interactions with antiretroviral."
They
added that, "The trend toward reduction in AST suggests possible benefit
and deserves further study."
Foundation for Integrative AIDS Research
(FIAR), Brooklyn, NY; Mount Sinai School of Medicine, New York, NY.
8/29/08
Reference
G
Carter, J Godbold, R MacKay, and others. Pilot trial of milk thistle in HIV/hepatitis
C co-infection. XVII International AIDS Conference (AIDS 2008). Mexico City. August
3-8, 2008. Abstract WEPE0185. |
