Phase I studies of hypericin, the active compound in St. John's Wort, as an antiretroviral agent in HIV-infected adults - AIDS clinical trials group protocols 150 and 258
Rm. Gulick et al., Phase I studies of hypericin, the active compound in St. John's Wort, as an antiretroviral agent in HIV-infected adults - AIDS clinical trials group protocols 150 and 258, ANN INT MED, 130(6), 1999, pp. 510-514
Citations number
20
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background: Hypericin, the active compound in St. John's Wort, has antiretr
oviral activity in vitro. Many HIV-infected persons use St. John's wort.
Objective: To evaluate the safety and antiretroviral activity of hypericin
in HIV-infected patients.
Design: Phase I study.
Setting: Four clinical research units.
Patients: 30 HIV-infected patients with CD4 counts less than 350 cells/mm(3
).
Intervention: Intravenous hypericin, 0.25 or 0.5 mg/kg of body weight twice
weekly or 0.25 mg/kg three times weekly, or oral hypericin, 0.5 mg/kg dail
y.
Measurements: Safety was assessed at weekly visits. Antiretroviral activity
was assessed by changes in HIV p24 antigen level, HIV titer, HIV RNA copie
s, and CD4 cell counts.
Results: Of the 30 patients who were enrolled, 16 discontinued treatment ea
rly because of toxic effects. Severe cutaneous phototoxicity was observed i
n 11 of 23 (48% [95% CI, 27% to 69%]) evaluable patients, and dose escalati
on could not be completed. Virologic markers and CD4 cell count did not sig
nificantly change.
Conclusions: Hypericin caused significant phototoxicity and had no antiretr
oviral activity in the limited number of patients studied.