The Effects of Propolis Extract Administration on HIV Patients Receiving ARV

Erwin Astha Triyono, Sarah Firdausa, Heru Prasetyo, Joni Susanto, James Hutagalung, Lilis Masyfufah, Budiono Budiono, Ivan Hoesada

Abstract


BACKGROUND: Human Immunodeficiency Virus (HIV) is an infectious disease that targets the human immune system by attacking cluster of differentiation (CD)4 cells. The use of propolis in HIV patients is expected to be safe and beneficial in terms of increasing endurance and immunity by its role in increasing CD4 level. This study aimed to analyze the influence of propolis supplementation in increasing the CD4 level in anti-retroviral (ARV)-treated HIV patients.

METHODS: Double-blind randomized controlled clinical trial was conducted in 50 HIV patients who took regular ARV therapy. The subjects were divided into two groups, one group was treated with ARV and propolis, while another one was given ARV and placebo. The CD4 cell count was measured during pre-treatment, in the 3rd month, in the 6th month after treatment. The level of hemoglobin, leukocyte, and platelets were also measured. The SF-12 questionnaire was used to evaluate quality of life of the subject.

RESULTS: Out of 50 subjects, 43 subjects completed the study, which were 19 subjects from the propolis group and 24 subjects from the placebo group. After 3-month of treatment, there was a statistically significant difference in the increase of CD 44 level in propolis group, while the increment was not significant in the placebo group. After 6-month treatment, the increase of CD4 level was occurred in both groups, propolis and placebo, however the increment was not statistically significant. The levels of hemoglobin, leukocyte, and platelets were not altered by the treatment and remained normal throughout the study. The quality of life was improved during the study; however, it was also not statistically significant. Mild adverse events occurred in 3 subjects which were relieved after the treatment stopped.

CONCLUSION: Based on the result of this study, the administration of propolis on HIV patients receiving ARV bring significant difference in the increase of CD4 in propolis group from baseline to 3 month after the treatment. While in placebo group, this increment was not significant. At the end of study, CD4 count continued to rise up, however the increase was not statistically significant. There are no hemoglobin, leukocyte, platelets, and quality of life abnormalities. Therefore, it is necesary to do further research with a spesific CD4 count. However, it may be beneficial in relieving the clinical symptoms and quality of life of patient living with HIV.

KEYWORDS: CD4, ARV, HIV, propolis


Full Text:

PDF

References


Halpin SN, Carruth EC, Rai RP, Edelman EJ, Fiellin DA, Gibert C, et al. Complementary and alternative medicine among persons living with HIV in the era of combined antiretroviral treatment. AIDS Behav. 2018; 22: 848-52, CrossRef.

Endale Gurmu A, Teni FS, Tadesse WT. Pattern of traditional medicine utilization among HIV/AIDS patients on antiretroviral therapy at a university hospital in northwestern Ethiopia: a cross-sectional study. Evid Based Complement Alternat Med. 2017; 2017: 1724581, CrossRef.

Cichello S, Tegegne SM, Yun H. Herbal medicine in the management and treatment of HIV-AIDS-A review of clinical trials. Aust J Herb Med. 2014; 26: 100, article.

Silva-Carvalho R, Baltazar F, Almeida-Aguiar C. Propolis: a complex natural product with a plethora of biological activities that can be explored for drug development. Evid Based Complement Alternat Med. 2015; 2015: 206439, CrossRef.

Gekker G, Hu S, Spivak M, Lokensgard JR, Peterson PK. Anti-HIV-1 activity of propolis in CD4+ lymphocyte and microglial cell cultures. J Ethnopharmacol. 2005; 102: 158-63, CrossRef.

Silva CCF, Salatino A, Motta LB, Negri G, Salatino MLF. Chemical characterization, antioxidant and anti-HIV activities of a Brazilian propolis from Ceará state. Revista Brasileira de Farmacognosia. 2019; 29: 309-18, CrossRef.

Olivero-Verbel J, Pacheco-Londoño L. Structure-activity relationships for the anti-HIV activity of flavonoids. J Chem Inform Comput Sci. 2002; 42: 1241-6, CrossRef.

Fesen MR, Pommier Y, Leteurtre F, Hiroguchi S, Yung J, Kohn KW. Inhibition of HIV-1 integrase by flavones, caffeic acid phenethyl ester (CAPE) and related compounds. Biochem Pharmacol. 1994; 48: 595-608, CrossRef.

Erdemli HK, Akyol S, Armutcu F, Akyol O. Antiviral properties of caffeic acid phenethyl ester and its potential application. J Intercult Ethnopharmacol. 2015; 4: 344-7, CrossRef.

World Health Organization. WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-related Disease in Adults and Children. Geneva: World Health Organization; 2007, article.

Ware Jr JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996: 34: 220-33, CrossRef.

Petoumenos K, Choi JY, Hoy J, Kiertiburanakul S, Ng OT, Boyd M, et al. CD4:CD8 ratio comparison between cohorts of HIV-positive Asians and Caucasians upon commencement of antiretroviral therapy. Antivir Ther. 2017: 22: 659-68, CrossRef.

Soroy L, Bagus S, Yongkie IP, Djoko W. The effect of a unique propolis compound (Propoelix™) on clinical outcomes in patients with dengue hemorrhagic fever. Infect Drug Resist. 2013; 7: 323-9, CrossRef.

Feleke D, Yemanebrhane N, Gebretsadik D. Nutritional status and CD4 cell counts in HIV/AIDS patients under highly active antiretroviral therapy in Addis Ababa, Ethiopia. J AIDS Clin Res. 2017; 18: 2-4, CrossRef.

Okoye AA, Picker LJ. CD4+ T‐cell depletion in HIV infection: mechanisms of immunological failure. Immunol Rev. 2013; 254: 54-64, CrossRef.

Maartens G, Celum C, Lewin SR. HIV infection: epidemiology, pathogenesis, treatment, and prevention. Lancet. 2014; 384: 258-71, CrossRef.

Abbas AK, Lichtman AH, Pillai S. Congenital and acquired immunodefciencies. In: Cellular and Molecular Immunology. 7th ed. Philadelphia: Elsevier Health Sciences; 2012. p. 445-70, NLMID.

Uppal S, Verma S, Dhot P. Normal values of CD4 and CD8 lymphocyte subsets in healthy indian adults and the effects of sex, age, ethnicity, and smoking. Cytometry B Clin Cytom. 2003; 52: 32-6, CrossRef.

Howard RR, Fasano CS, Frey L, Miller CH. Reference intervals of CD3, CD4, CD8, CD4/CD8, and absolute CD4 values in asian and non‐asian populations. Cytometry. 1996; 26: 231-2, CrossRef.

Xu HX, Wan M, Dong H, But PPH, Foo LY. Inhibitory activity of flavonoids and tannins against HIV-1 protease. Biol Pharm Bull. 2000; 23: 1072-6, CrossRef.

Ito J, Chang FR, Wang HK, Park YK, Ikegaki M, Kilgore N, et al. Anti-HIV activity of moronic acid derivatives and the new melliferone-related triterpenoid isolated from Brazilian propolis. J Nat Prod. 2001; 64: 1278-81, CrossRef.

Zhang X, Neamati N, Lee YK, Orr A, Brown RD, Whitaker N, et al. Arylisothiocyanate-containing esters of caffeic acid designed as affinity ligands for HIV-1 integrase. Bioorg Med Chem. 2001; 9: 1649-57, CrossRef.

Harish Z, Rubinstein A, Golodner M, Elmaliah M, Mizrachi Y. Suppression of HIV-1 replication by propolis and its immunoregulatory effect. Drugs Exp Clin Res. 1997; 23: 89-96, NLMID.

Yusuf WNW, Mohammad WMZW, Gan SH, Mustafa M, Abd Aziz CB, Sulaiman SA. Tualang honey ameliorates viral load, CD4 counts and improves quality of life in asymptomatic human immunodeficiency virus infected patients. J Tradit Complement Med. 2019; 9: 249-56, CrossRef.

Hermawan AG. Development of immunopathobiogenesis on SIRS-sepsis. Indones Biomed J. 2009; 1: 32-9, CrossRef.

Gaardbo JC, Hartling HJ, Gerstoft J, Nielsen SD. Incomplete immune recovery in HIV infection: mechanisms, relevance for clinical care, and possible solutions. Clin Dev Immunol. 2012; 2012: 670957, CrossRef.

Triyono EA, Firdausa S, Prasetyo H, Susanto J, Hutagalung JS, Masyfufah L, et al. The effect of propolis supplementation to CD4/CD8 ratio in HIV-infected patients receiving ARV therapy. New Armen Med J. 2019; 13: 85-94, article.

Tinago W, Coghlan E, Macken A, McAndrews J, Doak B, Prior-Fuller C, et al. Clinical, immunological and treatment-related factors associated with normalised CD4+/CD8+ T-cell ratio: effect of naive and memory T-cell subsets. PloS one. 2014; 9: e97011, CrossRef.

Serrano‐Villar S, Moreno S, Fuentes‐Ferrer M, Sánchez‐Marcos C, Avila M, Sainz T, et al. The CD 4: CD 8 ratio is associated with markers of age‐associated disease in virally suppressed HIV‐infected patients with immunological recovery. HIV Med. 2014; 15: 40-9, CrossRef.

Parinitha S, Kulkarni M. Haematological changes in HIV infection with correlation to CD4 cell count. Australas Med J. 2012; 5: 157-62, CrossRef.

Muhammad M, Mouchira M, Naglaa R. Physiological effects of bee venom and propolis on irradiated albino rats. Danish J Agricult Animal Sci. 2015; 2015: 11-21, article.

Yildirim A, Duran GG, Duran N, Jenedi K, Bolgul BS, Miraloglu M, et al. Antiviral activity of hatay propolis against replication of herpes simplex virus type 1 and type 2. Med Sci Mon Int Med J Exp Clin Res. 2016; 22: 422-30, CrossRef.

Bellegrandi S, D'Offizi G, Ansotegui IJ, Ferrara R, Scala E, Paganelli R. Propolis allergy in an HIV-positive patient. J Am Acad Dermatol. 1996; 35: 644, CrossRef.

Callejo A, Armentia A, Lombardero M, Asensio T. Propolis, a new bee‐related allergen. Allergy. 2001; 56: 579, CrossRef.

Lieberman HD, Fogelman JP, Ramsay DL, Cohen DE. Allergic contact dermatitis to propolis in a violin maker. J Am Acad Dermatol. 2002; 46: S30-S1, CrossRef.

Miguel MG, Antunes MD. Is propolis safe as an alternative medicine? J Pharm Bioallied Sci. 2011; 3: 479-95, CrossRef.




DOI: https://doi.org/10.18585/inabj.v13i1.1381

Indexed by:

                 

                  

               

     

 

The Prodia Education and Research Institute