The way many antiretroviral drugs, such as protease inhibitors, non-nucleoside reverse transcriptase inhibitors (NNRTIs) and Maraviroc, are predominantly metabolised means that some herbs can affect the serum levels of these drugs.
The long-term success of ART depends upon maintaining high enough concentrations of the drug to suppress viral replication. Drugs or herbs that interact with the way ART is processed by the body could result in reduced serum levels of ARV drugs, which could cause treatment failure and the development of ART drug resistance or increase serum levels of ART, which may increase side effects.
In many cases the interactions are theoretical and little is known on how such potential interactions demonstrated in the lab (in-vitro) might be translated into clinically significant effects in people (in-vivo). More research is needed to establish the clinical significance of herbs with ART. So far the known interactions are confined to the drug classes: protease inhibitors, non-nucleoside reverse transcriptors and Maraviroc. To date the nucleoside reserve transcriptors, fusion inhibitors and Raltegravir have not shown any interactions with herbal medicines.
