African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology

The use of traditional medicine and Natural Health Products is widespread among those living with HIV infection [1]. Many patients take a broad range of natural health products (NHPs) in addition to their conventional therapeutic products [2-4]. In Africa, traditional herbal medicines are often used as primary treatment for HIV/AIDS and for HIV-related problems including dermatological disorders, nausea, depression, insomnia, and weakness[2,5-8]. Some herbal and traditional medicines are not well-researched, poorly regulated, may contain adulterated products, and may produce adverse effects [8-13]. Notwithstanding these concerns, the use of traditional medicines by Africans living with HIV is believed to be widespread, although insufficiently documented [14-16].Despite a paucity of evidence on effectiveness, and the possibility of harm, the Ministries of Health of several African nations currently promote traditional medicines for the treatment of HIV and associated symptoms [12,17]. In the case of South Africa, the Ministry of Health is actively promoting the use of traditional medicines with antiretroviral treatments[18].Two principal African herbal compounds used for HIV/AIDS treatment in sub-Saharan Africa include Hypoxis hemerocallidea (common name: African potato), and Sutherlandia. These two herbal remedies are currently recommended by the South African Ministry of Health for HIV management [17]. The 14 member states of the South African Development Community (SADC) which includes Angola, Botswana, Democratic Republic of Congo, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe, also support their use [19]. Responding to the compelling need for evidence regarding traditional medicines, we reviewed the current evidence for the use of these herbal remedies in HIV care.With the aid of an information specialist, we searched the following databases independently, in duplicate (from inception to Dece