Viral Diseases and Complementary Medicine

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Sections

Hepatitis, or Liver inflammation due to various viruses

Hepatitis C is a very prominent chronic viral illness that now affects a sizable portion of the population of the United States. Hepatitis B is a type of viral liver inflammation that was widespread over much of the world in the past, especially in Asia and Africa, and is now endemic in China (maintained as a chronic infection in the population, mainly via transmission during birth). Hepatitis B has infected more than 2 billion people worldwide, and it is thought that more than 350 million people around the world are chronic carriers of the virus. In order to downplay the subject of viral inflammatory disease of the liver in the past, health authorities have told us that this is a disease confined to drug addicts and sexually promiscuous individuals. This is the same public health tactic that was applied to the HIV retroviral infection. These viral illnesses were also characterized as dooming one to serious health consequences or death. The result of this massive misinformation is now finally emerging as a serious public health threat that must be dealt with finally in an open and honest manner. If hepatitis, or chronic liver inflammatory disease, is not treated in a sensible manner, it may lead to liver cancer, as well as other serious health problems related to poor liver function. There is a variety of treatment approaches that the person with hepatitis can utilize to protect their health, as well as to diminish the effects of the viral infection. Doing nothing, ignoring the liver inflammatory disease until it finally stimulates untreatable liver cancer or other serious disease, or waiting until the one simple miracle drug appears, is not the way to deal with chronic viral liver disease.

Standard treatment for Hepatitis C has been problematic, as a harsh combination of synthesized interferon and protease inhibitors are prescribed for a prolonged period, and the adverse side effects are often harsh, while the long-term efficacy is poor in many cases. In 2014, Gilead Sciences Inc. introduced a new drug to supposedly cure Hepatitis C, but the price was about $1000.00 per pill, and a full course of the treatment was about $84,000. The new drug, Sovaldi, or Sofosbuvir, is the first drug that has demonstrated safety and efficacy without the concurrent use of interferon therapy. The drug works by inhibiting the viral RNA polymerase needed to replicate the virus. Similar RNA polymerase inhibitors have been developed as broad spectrum anti-viral vaccines, but long-term potential for adverse effects of inhibition of key genetic mechanisms will not be known for perhaps a decade.

The first thing a person needs to do when suspecting that they may have a form of hepatitis is to get tested. This testing has been severely discouraged in the United States, as the medical doctors and public health authorities promoted the idea that hepatitis was a disease limited to drug addicts and sexually promiscuous individuals. This is and was far from the truth. In fact, modern science still is not sure how so many cases of hepatitis are transmitted. The real fact is that there is not a sound treatment protocol for hepatitis, and so the standard medical establishment has not wanted to deal with this dilemma. The patient, and the general public, should take a proactive approach to this health threat and proceed in a positive manner to educate themselves, and to do all the right things to either prevent the disease, treat the disease, prevent the spread of the disease, and/or improve the health of the immune system and liver to prevent serious consequences of the disease, especially liver cancer, which is one of the most fatal of cancers, and autoimmune disease, which is associated with a percentage of patients prone to hepatitis. This is where the patient and the Complementary Medicine physician can work together to arrive at the best outcome. Herbal medicine research is finding more and more natural chemicals with potent antiviral effects, immune modulating effects, liver protecting effects, etc. Nutrient medicine is progressing by leaps and bounds to help the physician stimulate healthy physiology and restore homeostatic balance. Acupuncture research is uncovering the complex ways that specific needle stimulation exerts potent anti-inflammatory, neurohormonal, and immune modulating effects. The combination of these therapies offer the patient an array of therapies to address all the negative health aspects of hepatitis.

After testing and finding out that you are infected by one of the hepatitis viruses, the next thing that the sensible patient needs to do is to educate themselves. Hepatitis is a term that literally means liver inflammation, and is a nonspecific term. There are a family of viruses that we refer to when we use the term hepatitis, and in fact a family of viruses, or species genus, that we refer to when we use the terms Hepatitis B, C etc. This is one reason why the allopathic approach, which targets a specific virus, is a failure. Hepatitis B virus, or HBV, is a species of the genus type Orthohepadnavirus. Hepadnaviruses are a family of viruses that cause liver inflammation in humans and animals and have been around for millions of years. For all our scientific study, we still do not understand this family of viruses well enough to explain how many people with the viral infection do not show symptoms, while others have a severe acute illness, and many others eventually have severe diseases many years after the infection. The specific Hepatitis B that we study is similar to a retrovirus. The retrovirus is a type that replicates by becoming part of a cell's DNA and stimulating its genetic code via RNA replication. The Hepatitis B virus that we have created a vaccine for has a double encapsulation of lipid and protein around a bit of non-living genetic material, or DNA, that ends with a DNA polymerase enzyme. There are 8 known types of prevalent Hepatitis B in the world to deal with. These are labeled A through H, and the variations between these genotypes are in about 8 percent of the gene sequence. Various parts of the world are predominantly affected by the various types of Hepatitis B.

There are parts of the hepatitis B virus that are common to all types, and the vaccine created addresses these similarities, especially the surface antigens on the lipoprotein capsules. The vaccination against Hep B stimulates an antibody response to the surface antigens found on most hepatitis B viruses. While this vaccination has been shown to be highly successful in most cases, about 10 percent, or 1 in 10, individuals that are vaccinated do not respond with a sufficient antibody response to the surface antigens, and this leads to questions about the immune system and the response to vaccination. In addition, long term studies have shown that the vaccine stimulates a sufficient antibody response for about 15 years, although infants and children younger than 4 appear to lose this antibody response sooner than adults. Since many people have become infected at birth by exposure to the parent's virus in the birthing fluids and blood, immunization vaccine is always recommended at birth for babies born to a mother that has tested positive in the past for Hep B.

The immune system problems seen in Hepatitis patients

A percentage of people have been found to be nonresponsive to the hepatitis B vaccine, and the Mayo Clinic determined in 2003 that there is a strong association between a genetic inheritance of the DQ2 human leukocyte antigen (HLA) genotype, as well as celiac disease (hyperresponsive immune antibody reaction in the intestinal lining to glutens and gliadins) (PMID: 14572581). The Mayo Clinic concludes that a humoral immune deficiency is linked to both hepatitis vaccine nonresponsivenes and celiac disease. Researchers in Europe had previously concluded that the prescence of autoimmune antibodies to smooth muscle (organ tissue such as the liver) cells is common in Hepatitis B infection, and that most autoimmune diseases do not develop until later in life (PMID: 12093985). These clear links to immune dysfunction and deficiency point to the need to incorporate a more thorough treatment protocol with Integrative and Complementary Medicine, not only vaccinating against and treating the viral disease, but also stimulating increased immune function, resolving celiac disease and GI dysfunction, and also aiding the health and function of the liver.

The Herpes family of viruses

The family of viruses called Herpes affects a large percentage of the human population worldwide and has a documented history that extends at least to the Roman Empire, with the Emperor Tiberius attempting to curb the spread at one time by outlawing kissing in public. In 2015, the first estimate of global herpes incidence by the World Health Organization (WHO) occurred, and it was indeed confirmed that 2/3 of the world population has the herpes virus in their genetic code, with more than 3.7 billion people estimated to have the HSV-1, usually acquired in childhood, and 417 million people between the age of 17 and 49 with HSV-2. Obviously, only a small percentage of these people are expressing herpes lesions, and this expression of sores or blisters is extremely variable in the population, indicating that immune health and function is the key to the disease, or rather the neuroimmune function. Today, symptoms related to Herpes simplex types 1 and 2, commonly called cold sores and genital herpes, as well as shingles, varicella and other types are common, and often recur episodically, infecting the genes of cells, usually in the nerve sheath. The Herpes simplex virus has evolved to bind to the main immune complement C3 protein, and deleting it, as well as producing gE and gI proteins that bind with IgG antibodies and hide it from the immune response. It is thought that the strongest protections against the immune complement response occur in nerve sheaths near the spinal cord, causing a localized pattern of outbreak along a dermatome.

Cross-infection occurs when blisters retain fluid, and various degrees of episodic expression are seen, stimulated by stress, sun exposure, and mild fever, commonly with a prodrome that can be detected, involving mildly swollen lymph nodes, malaise, headache and muscle ache. Acyclovir, famciclovir, and valacyclovir are prescribed, and often have limited effect, and a growing incidence of acyclovir-resistant cases has emerged. A 2006 study of records showed that 371,000 were diagnosed and treated with genital herpes in the United States, but public health experts assume that a vast majority of cases are not reported in standard medicine. It has been widely estimated that 50-80 percent of U.S. adults have, or have had in the past, oral herpes. In some studies worldwide, 90 percent of children showed HSV-1 antibodies. A 2015 report by the World Health Organization showed that an estimated 60 percent of adults in the world have a Herpes simplex infection. The standard model of infection, limited to exchange of virally expressed bodily fluids, does not explain all cases. Incidence is much higher in immune suppressed individuals. It is time that we adopted a more realistic attitude to the Herpes virus, and take measures to decrease the episodic symptoms that occur. It is clear that we cannot treat Herpes as a simple infection with two-thirds of the world having this viral DNA in their genes. A more holistic approach is needed, and Complementary and Integrative Medicine and TCM provides an array of therapies that are proven to both counter the Herpes expression and support the immune function, as well as help decrease the the underlying causes that are responsible for increased episodes of symptoms.

By 2014, we see abundant evidence for the efficacy of herbal medicine to treat the herpes viral infection, but very little utilization in the United States. Treatment with topical herbal ointments that include Melissa balm and Larrea is now common in Europe, yet seldom seen in the United States. Obviously, the treatment with herbal extracts for the herpes viral expression would have to include both topical and internal medicines, since the virus resides deep in nerve sheaths extending back to the spine. Research in 1996, at the New York University School of Medicine, United States, (Bourinabaiar AS, Lee-Huang S), showed that antiretroviral proteins in the herb Momordica charantia (Bitter Melon), as well as Gelonium multiforum, showed that the herbal extracts were 2-3 times more potent than acyclovir against the common strains of Herpes simplex types 1 and 2 that showed resistance to the drug acyclovir (PMID: 8645280). In addition, the herb Glinus oppositifolius (Chang geng xing su cao) has now also been well studied and long utilized to treat Herpes in China and Taiwan, and active chemicals include a number of amino acid derivatives, Kaempferol and polysaccharides that inhibit Herpes replication in a number of ways. Each year we are seeing proof of efficacy of herbal medicine to counter the expression of the Herpes virus in our cells, and some of this research is provided in the section of this article entitled Additional Information and Links to Scientific Studies.

Human immunodeficiency virus (HIV) and the implications of the failure of our approach worldwide to eradicate the widespread infection rate of this family of retroviruses

Human immunodeficiency virus, or HIV, refers to a group of lentiviruses, or slowly replicating retroviruses, not a single virus. A retrovirus is a bit of RNA encapsulated in a shell that infects the host cell DNA and uses its own reverse transcriptase enzyme to produce its own DNA from the viral RNA genome, and incorporate this bit of DNA into the host cell DNA. These slowly developing lentiviruses are usually undetectable in the first 9 months of infection by PCR (polyerase chain reaction) testing. Since the HIV/AIDS pathology is defined by its effects on immune dysfunction, not direct viral symptoms, integrating Complementary Medicine to achieve improved immune function and restorative immune modulation seems essential, yet despite its wide use by patients worldwide that are infected with HIV strains, it has been heavily discouraged, with no actual proof of harm. This proscription against CIM/TCM in HIV/AIDS care has also delayed serious scientific study of herbal medicine as an effective antiviral complement, or adjunct to pharmaceutical treatment, but finally, world health experts are seeing proof of efficacy and no direct reasons for biological contraindication for almost all herbal medicine.

A retrovirus is an enveloped virus belonging to the viral family Retroviridae, which stores its data in the form of an RNA strand, and not a DNA strand, utilizing reverse transcription to express protein encoding DNA. In most cases within the genetic code of a cell, DNA expresses RNA, which expresses signaling proteins. Endogenous retroviruses make up approximately 8 percent of the human genome. HIV retroviruses are found to infect immune cells, specifically CD4-plus T-cells, macrophages, and microglial cells. HIV differs from many other pathogenic viruses in that it has a very high genetic variability, thought to be due to a fast replication cycle. This may lead to the generation of many variants of HIV in a single infected patient in the course of one day. This trait has made pharmaceutical control of HIV difficult, and a number of cocktails, or multidrug protocols, have been created, and often need to be changed, as the virus adapts to the treatment. HIV may exist in a latent form for a very long period without causing immunodeficiency, and induced into a productive, or active, form by a number of cellular signals. Patients infected with a strain of HIV and without a detectable immune deficiency may benefit from a holistic and thorough health protocol to strengthen the immune systems and protect against opportunistic infections. A healthy balance between the innate and acquired immune systems has been shown to perhaps be the key to preventing the retrovirus from creating serious immune deficiency, as these two systems modulate one another to both stimulate a variety of immune responses, and to keep these immune responses in check.

We are still learning basic aspects to the HIV infection. For instance, in 2015, researchers at Harvard and MIT released the findings of an initial study of a comprehensive test for viral antibodies, called VirScan. In this test, 569 individuals in 4 countries, on 4 continents, were tested for the presence of viral antibodies to the 100 most well-known pathogenic viruses, and an average of 10 were discovered, with up to 84 viral antibodies of 100 tested in 2 individuals. Some surprising findings occurred, such as the fact that so many individuals produced the same antibodies that targeted the same region on the same viruses. The most surprising uncovery, though, was that persons infected with HIV did not show the expected diminished response to viral infection, but instead an exaggerated response to almost every other virus. The depiction of HIV as causing an acquired immunodeficiency syndrome (AIDS) may have to be revised, as the disease mechanism appears to be an acquired immune excess response. That we have just now, in 2015, discovered this, after the enormous research into HIV/AIDS is unbelievable. The current strategy for HIV/AIDS is to provide HAART (highly active antiretroviral therapy) to prevent this excess immune response from creating an overall decreased response to common pathogens. While it is obvious that the goal of slowing HIV infection to allow restoration of overall immune function would be greatly aided by integration of Complementary Medicine, both in improving immune health and function, and in helping to inhibit HIV replication, there has been an inexplicable discouragement of Complementary and Integrative Medicine and TCM instead. Many studies of the ability of herbal chemistry, and acupuncture, to achieve healthy modulation of immune responses, not just specific immune suppression, show the potential for CIM/TCM in this integrated treatment protocol.

The United States Centers for Disease Control and Prevention estimated in 2011 that 1,155,792 patients received a diagnosis of AIDS since the viral infections began, and that over 32,000 new diagnoses per year occur, with more than 1/4th of these heterosexual women, mainly acquiring the infection through sex with infected men. The entire population is affected by HIV retroviral infection, and much more needs to be done to achieve a comprehensive halt to this family of pathogenic viruses. Complementary Medicine has largely been discouraged in the protocol of prevention, treatment, adjunct therapy, and improvement in immune defenses, and this is a mistake. Programs that have encouraged the use of Complementary Medicine, especially Traditional Chinese Medicine, with acupuncture, herbal and nutrient medicine, have been proven to be highly effective and successful, yet funding has been cut, and standard medicine continues to discourage this integrative treatment protocol. Patients tested positive for HIV should do all that they can to support a healthy immune system and decrease the growth of viral loads in their bodies, hopefully before a diagnosis of AIDS occurs. Knowledge is the key to success, and while pharmaceutical drug protocols continue to improve, and have had great success in limiting the devastating effects of immunodeficiency syndrome, more could be accomplished, both in treatment and prevention.

By 2015, it is widely acknowledged that a principle concern in pharmaceutical anti-retroviral therapy is HIV-1 Transmitted Drug Resistance. A large multicenter study involving the World Health Center and numerous university research centers in a number of countries reviewed genetic studies of over 50,000 patients in from 111 countries and found that 20 gene mutations accounted for at least 70 percent of resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs), and of 763 viruses with drug resistance acquired, 95 percent were genetically dissimilar. The conclusion reached was that most transcriptase drug resistance arose independently, and that point-mutation assay tests may detect the mutations in pre-therapy screening to improve drug cocktail design (PMID: 25849352). While this is a needed approach to counter this growing problem, most research and treatment institutions do not mention the changing complexity of this viral drug resistance and its implications for the future. For those numerous patients infected by one of the many variants on the 4 strains of HIV family now known that evolve drug resistance but do not fall in the 70 percent involving more serious drug resistant traits, such testing may not screen effectively, and the continued protocol of changing the drug cocktail when it is not working will continue. If this problem worsens in the future, the overuse of anti-retroviral drugs will result in the same dilemma as we now face with antibiotic-resistant bacterial infections. Many experts agree that a more comprehensive approach is needed, with more emphasis on a decrease in HIV transmission, improved immune protections, and earlier intervention, rather than a complete focus on later stage management of the disease or infection, which is also very costly. CIM/TCM could increase these aspects of disease prevention and early intervention, but is at present widely discouraged.

Early drug intervention is being initiated, but often a harsh cocktail of drugs is prescribed before a definitive diagnosis is achieved. Diagnosis of HIV is achieved initially by a test for HIV-1 antibodies (ELISA), which if positive, needs to be repeatedly retested, and if these are positive, needs to be backed up with a more specific test, such as a Western Blot, or immunofluorescence assay (IFA). Nucleic acid testing is a more specific test to confirm diagnosis as well. Often, the initial tests are not conclusive, yet IFA and Nucleic Acid tests are rarely used. Currently, the single screening is considered accurate 99 percent of the time, but this is still a controversial statistic. Testing is recommended to be be repeated in guidelines, and the standard of a 2-step testing protocol is considered to be able to produce a false-positive of about 1 in 250,000. Pharmacological treatment of HIV infection is recommended for patients with a sizable viral load and a CD4 count that has fallen below 500. Since 2008, when a small study showed that risk of transmission of HIV may be reduced when the viral load is undetectable with ELISA assay, or under 1500 copies per millileter, and rates of transmission are lower in persons with a lower viral count (38,029 copies per milliliter (Quinn TC et al, Rakai Project, 2000), the U.S. CDC has recommended that HIV-infected persons that are sexually active should utilize the continuous chronic use of the HIV/AIDS cocktail to reduce transmission (viral load has been shown to increase within a month after stopping drug therapy, or when the virus mutates and the drug regimen fails). The CDC states, though, that "sexual transmission of HIV from an infected partner who was on ART with a repeatedly undetectable plasma viral load has been documented (Sturner M et al, 2008)."

There is fear that promotion of the idea that HIV is not transmittable when utilizing a multi-drug regimen may lead to increases in unprotected sex and infection of partners. For this reason, protected sex is still highly recommended for infected persons. The transmission of new cases of HIV infection through unsafe practices with injectable drugs is also a concern that affects not only drug users, but their sexual partners as well, and encouraging widespread adoption of safe injection protocols at specialized clinics is finally becoming more popular as well. Providing supervised injection sites not only prevents the spread of disease, but encourages greater participation in programs to stop drug addiction, without the prohibitive cost of widespread prison terms for drug addicts, which have proven to be ineffective to discourage drug use and addiction over the last 50 years. These protocols, as well as the inclusion of Complementary and Integrative Medicine (CIM) into the HIV prevention protocol, may finally stop the number of new cases in the U.S. from increasing. The hope that decreased viral load may be demonstrated with a holistic treatment protocol is spurring a renewed interest worldwide in herbal and nutrient research, perhaps adding to the possibility that transmission of HIV will be further reduced with a safe, simple, and inexpensive integrative treatment model. Such research can finally be applied to the situation in the U.S. as well, not as an alternative to HARRT, but as an integrated Complementary Medicine.

One reason for a renewed interest in integrating Complementary Medicine into the present prevention and treatment strategy for HIV/AIDS is cost effectiveness. Currently, the costs of the Plan A model of the U.S. Centers for Disease Control and Prevention (CDC) is estimated at $41,667 per each new HIV diagnosis, and for Plan B, a cost of $7,400 per diagnosis. The lifetime treatment cost average, funded by the government, is estimated by the CDC is $379,668 per person in 2010, with the annual cost of multidrug therapy (ART) estimated at $23,000 per year in 2010, and by 2015, estimated at $30,000 per year in San Francisco. The estimated infection rate in the U.S. has not significantly changed since 2006, with an estimated 48,000 new infections diagnosed per year. Annual spending for HIV/AIDS activities by the U.S. federal government has reached $28.4 billion. Reducing the rate of infections further with a more comprehensive strategy is considered the number one priority at present. If there is proof that such protocols as herbal medicine may provide increased effectiveness for both decreased viral load, and support of immune function to counter the routes of infection and transmission, this would lead to an inexpensive addition to the multifactorial prevention and treatment strategy. With little research to date verifying this efficacy in 3-stage human clinical trials, though, Complementary Medicine has played a significant role for many patients as an adjunct therapeutic strategy to maintain optimal health after infection, and to counter the significant long-term adverse health effects associated with standard drug protocol.

The Hope for a Functional Cure of HIV/AIDS with a more comprehensive and holistic treatment protocol that is individualized and flexible

While many decades of extensive research and development of HIV/AIDS drugs have failed to find a cure, in 2013 evidence has emerged that there are proven cases of functional cure and approximately one percent or more of patients infected appear to be spontaneous HIV controllers, meaning that their immune systems appear to keep the virus in check, or viral count low to undetectable, without the drug cocktail, or HART. While the case of a child born with HIV infection and treated for nearly 2 years before her mother decided to stop the pharmaceutical treatment due to adverse effects, and the viral load remained undetectable 2 years later, achieving a 'functional' cure, became a much publicized story, these cases have been noted clinically for decades. A study published in 2013, in the journal PLOS Pathogens, of post-treatment controllers (viral load undetectable 2 years after stopping pharmacological therapy) demonstrates that experts in the field have been aware of a significant incidence of this phenomenon for decades (Saez-Cirion A et al ANRS VISCONTI Study). In this study, 14 HIV-infected patients with longstanding viral control after discontinuation of drug therapy were studied to see what distinguished these patients. The researchers found that patients started on antiretroviral therapy in the preliminary stage of infection, rather than the chronic stage, achieved a mild advantage after discontinuation of the drug protocol HART, with higher CD4 counts, and viral rebound occurring later and at a lower level. While this advantage appears temporary, the researchers noted that a small but significant percentage of patients studied after interruption of drug treatment, since 2010, continued to have a post-treatment control of HIV viral loads. Genetic alleles were analyzed, as a high percentage of spontaneous controllers had a protective HLA type (human leukocyte antigen, or MHC, major histocompatibility complex, a locus of immune genetic code). The post-treatment controllers did not show a protective genetic HLA type allele. What distinguished these post-treatment controllers was a low T cell activation status and low HIV reservoir level. In other words, patients with the HIV successfully treated and who remained healthier and whose immune system kept the inactive HIV retroviral DNA expression lower had a much better chance of a functional cure, or ability to preserve undetectable HIV counts in circulation and no syndrome of immunodeficiency, with the drug cocktail. With such research continuing, there is a strong possibility that integration of Complementary Medicine could play a significant role in achieving these results. Why such patients, who opt to discontinue drug therapy due to side effects, are not encouraged to at least utilize professional Complementary Medicine during these phases of monitoring while off of drug therapy, should be questioned.

One aspect of the search for functional cure, or at least a more benign long-term treatment strategy that is more in line with the reality that a large percentage of patients discontinue their pharmaceutical treatment due to adverse health effects, is the subject of HIV superinfection, and the diverse mutation of the virus in the host, in response to therapy, or because the innate immune response is not sufficient. HIV superinfection, or sequential infection with variants of the type of HIV in the original infection, has long been a concern of experts and public health officials, yet has been vociferously attacked. Subsequently, little sound research has been published on this subject. One of the only sound studies on superinfection was conducted in 2005, by Dr. Frederick M. Hecht of the University of California San Francisco AIDS Project, where all patients enrolled in a small cohort study of newly infected HIV patients receiving a course of pharmaceutical treatment for at least 12 weeks, then stopping this type of drug therapy, and monitored for a return of significant viral load and fall of CD4 counts, were tested for HIV superinfection. A total of 104 patients were followed, and the lack of a second HIV viral type at baseline of diagnosis was confirmed. Typical results of follow-up showed that after about 10 months, a different virus than the original was detected, resulting in a sharp increase in viral load and decline of CD4 count. Dr. Hecht stated that superinfection appears to be relatively common in early HIV infection. The search for a more thorough protocol to prevent this sequential infection with variants of the original HIV retrovirus is integral to the hope for a functional cure, and Complementary Medicine may provide a bigger array of integrated treatment options to advance this hope. While standard medicine may continue to discourage Complementary Medicine for some time, sticking to the neurotic idea that it is a competing or alternative medicine, patients worldwide are waking up to the fact that this integrative medicine is both safe and helpful, with many potential benefits.

With more than 1000 children born each day in the world infected with HIV, the search for a functional cure for many of these individuals is important. A growing group of researchers are looking for pediatric functional cures around the world, funded by amfAR, the Foundation for AIDS Research, and the NIH. Such esteemed medical doctors as Dr. Deborah Persaud of Johns Hopkins, and Dr. Katherine Luzuiaga of the University of Massachusetts, are exploring all evidence of such functional cures in recent years. The hope is that early treatment will achieve the goal, and that these individuals do not have to be drug-dependent the rest of their lives. While all infants of HIV infected mother are tested positive for HIV antibodies, only about a third are positively identified with an actual HIV infection with more sophisticated tests. While a course of antiretroviral drugs during pregnancy reduces the rate of infection, as well as early prophylactic drug therapy after birth, we are now exploring the possibility of adding to this potential with herbal chemicals. The fact that a large percentage of patients eventually discontinue the drug protocol due to adverse effects, or find that they have the retrovirus has mutated, or become resistant to the therapy, points to the fact that a larger perspective needs to be developed. Discouragement of a broader protocol for HIV/AIDS therapy, and posing this as a threat to the present protocol, has not been helpful.

While Complementary Medicine is not expected to provide a sound alternative to drug therapy (ART), or a cure for HIV/AIDS, integration of these protocols has been a useful and healthy adjunct to treatment for decades, and promises to provide the patient with even more direct benefits to support immune function and reduce viral load before initiation of antiretroviral drug therapy (ART), if the ART fails, when adverse health effects spur stoppage of the ART, or to increase the effects of ART with concurrent use, perhaps leading to reduced dosage needed, and less side effects. Continued research into this field of medicine will yield more and more guidance for such integrated therapy. In the meantime, use of TCM therapy as an adjunct to HAART is widely prescribed, and shown to provide a host of benefits to maintaining health and quality of life when taking a harsh regimen of antiretroviral drugs with many adverse long-term health consequences. In many cases, clinics specializing in HIV/AIDS have utilized Chinese herbal formulas concurrently with ART (antiretroviral therapy with drugs) with no significant negative effects, receiving much positive feedback from patients.

The controversies surrounding chronic use of the HIV/AIDS cocktail of drugs and non-compliance due to adverse health effects

Since 2006, the profits from sales of antiretroviral drugs has soared, with the cocktail, or multidrug regimens, averaging about $16,000 per year, and the number of prescriptions soaring in the U.S. and the world. Despite the increase in prescriptions, an increase in the number of cases has been noted in the U.S. An increased push to provide more people with the antiretroviral drugs has also occurred, with one small study demonstrating a potential reduction in transmission of the infection in patients with an undetectable HIV viral count on the HIV cocktail of drugs, used to push the use of the multidrug regimen lifelong for patients with no discernible immunodeficiency, or low CD4 count. Other studies, cited by the U.S. CDC show that HIV infection is shown to occur from patients with an undetectable viral load and on the multidrug cocktail. This large increase in the number of HIV antiretroviral multidrug regimen prescriptions to healthy patients not yet affected by AIDS, but HIV positive, comes despite recent findings that patients with AIDS now have a life expectancy equal to the normal population. The goals of medicine should now focus on providing a better quality of life to HIV positive individuals, as well as increased understanding of the persistence of high transmission rates. The question of finding a treatment protocol that is better individualized and provides both protection and a better quality of life seems largely ignored in the politics and profit of the treatment of HIV/AIDS. Complementary Medicine could be integrated into this scheme professionally to achieve these goals, but the politics of HIV have largely negated these promising medical treatments, instead focusing purely on the increased pharmacological profits.

One of the most well-known activists for this push of increased drug treatment was Spencer Cox, the star of the Oscar-nominated documentary, How to Survive a Plague. With rising HIV/AIDS infection rates among young gay men, Mr. Cox was a dynamic role model. Unfortunately, on the eve of awards for this documentary, Mr. Cox died of what were described as "AIDS-related causes", resulting from his decision to stop taking the cocktail, or multidrug antiretroviral protocol. The health consequences of the drug cocktail had taken their toll, with lypodystrophy (redistribution of stored fat with accumulation on the neck, upper back, abdomen, breasts, and fat wasting in the limbs, as well as occurrence of lipomas), and metabolic disorders, loss of vitality, and depression. Apparently, non-compliance with his multidrug HAART regimen led to a sudden rise in viral load and immunosuppression. The causes of this non-compliance are still not addressed by the medical community, and a viable solution has not been proposed.

In a stunning push to explain the widespread, but underreported, non-compliance of antiretroviral drug therapy (HAART), a study was published in 2007, associating use of herbal medicines, multivitamins, psychic healing, or bodywork with non-compliance, and then purporting that professional Complementary Medicine may be "linked" to this non-compliance. The publication, entitled Complementary and Alternative Medicine Use Decreases Adherence to HAART in HIV-positive Women, surveyed 366 HIV-positive women in Alabama and Georgia who were enrolled in intervention to reduce high-risk sexual behavior, and reported that more women using any of these interventions were non-compliant with their HIV/AIDS cocktail for at least one day in the last month than those that did not use herbs, vitamin, bodywork, or psychic healing. This study is used to purportedly warn patients and physicians of the dangers in utilizing Complementary Medicine. Obviously, this is ridiculous, but it is taken seriously. Of course, in this small and strange study, there is no mention of acupuncture and professional herbal TCM medicine. Nevertheless, a warning was issued: "it should alert clinicians to exercise renewed vigilance regarding compliance in those cases in which patients use herbal, religious, or other alternatives to conventional evidence-based healthcare." What is overlooked in such study is the lack of serious study of the real reasons for non-compliance, which are the devastating long-term health consequences of the multi-drug regimen. Complementary Medicine provides a real treatment for these adverse health effects, yet is demonized, discouraging more and more HIV-positive patients from seeking effective care that could decrease symptoms and adverse health problems, and perhaps prevent such tragedies as the death of Spencer Cox.