Don't Miss HIV Patients' Alternative Medicine Use

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 has been shown not to affect CD4 cell counts, viral load, or antiretroviral levels, he said. Efavirenz use may cause positive results on marijuana drug tests, he added.