Fish oil has also been shown to decrease triglyceride levels.
▸ Milk thistle. Milk thistle could be attractive to HIV patients who are on antiretrovirals and/or coinfected with hepatitis B or C because its active ingredient, silymarin, may be hepatorestorative.
At the dosages used, it probably does not interfere with the efficacy of protease inhibitors.
Although the data are inconclusive, “I do know some hepatologists who are prescribing milk thistle for their hepatitis C patients,” he said.
▸ Acupuncture. Acupuncture is widely used by HIV patients for pain and neuropathy. One study of 215 patients reported that neither acupuncture nor amitriptyline was more effective than placebo (JAMA 1998;280:1590–5). But most acupuncturists say that the procedure is difficult to study rigorously because treatment is highly individualized, Dr. Tokumoto said.
▸ Marijuana. Anywhere from 14% to 43% of HIV patients may use marijuana medicinally or recreationally. Because of the political climate, marijuana use has not been studied in clinical trials.
But smoking marijuana over a short period of time has been shown not to affect CD4 cell counts, viral load, or antiretroviral levels, he said.