Determinants of Use and Antiviral Activity of Moringa Oleifera Extracts among People Living With HIV and Aids Attending Comprehensive Care Clinic at Migori County Referral Hospital, Kenya

Abstract

Moringa oleifera (M. Oleifera) is widely used as source of nutrition and as traditional medicine for the treatment of various diseases. Herpes simplex infection is among the major opportunistic infections among people living with HIV/AIDS (PLWHA). To date, there is no vaccination against the Herpes simplex virus type 1(HSV-1) and the recommended antiviral drugs have only a modest effect against the virus. The aim of this study was to determine the determinants of use and antiviral activity of Moringa oleifera extracts among PLWHA attending Comprehensive Care Clinic (CCC) at Migori County Referral Hospital. The study was cross-sectional in which 278 PLWHA attending CCC at Migori County Referral Hospital were selected by systematic sampling while 9 herbalists were sampled through the snowballing technique. Quantitative data was collected using semi structured questionnaires and analyzed in Statistical Package for Social Sciences (SPSS V.22). Chi-square test was used to compare categorical variables with a level of significance at p ≤ 0.05. M. Oleifera leaves were collected from the field and botanically identified at the University of Nairobi Herbarium. Aqueous and methanol extracts were tested for cytotoxicity by tetrazolium dye (MTT) and anti-herpes activity screened by cytopathic effect reduction and MTT assay using Vero cells and HSV-1. The study revealed that M. Oleifera is commonly (75.5%) used among PLWHA attending comprehensive care clinics (CCC) at Migori County Referral Hospital. The socio-demographic profile indicates that, age was the only significant factor associated with the use of M. Oleifera among PLWHA attending comprehensive care clinic. The commonly used part of the tree was the leaves (64.3%). The majority of the respondents (99%) had not experienced any side effects after using M. Oleifera together with HIV drugs. The findings indicate that distance to the health facility and the long awaiting time during health facility visits were the two significant health systems level factors associated with the use and non-use of M. Oleifera. Aqueous and methanol extracts of M. Oleifera are not toxic to vero cells and have antiviral activity against HSV-1. There is a need to formulate policy and legal framework to govern the herbal medicine practices among PLWHA attending CCC at Migori County Referral Hospital. Sensitization of people against stigma towards PLWHA is required. Specific phytochemicals responsible for antiviral activity against HSV-1 in aqueous and methanol extracts need to be isolated and further investigated for anti- HSV-1 activity in vivo and clinical trials.