REVIEW

Comprehensive review on treatment of HIV

Muhammad Daniyal1*, Muhammad Akram2, Abdul Hamid3, Allah Nawaz4, Khan Usmanghani5, Saeed Ahmed6 and Leena Hameed1 1Faculty of Eastern Medicine and Surgery, Hamdard University, Karachi, Pakistan 2Department of Eastern Medicine and Surgery, Faculty of Medical and Health Sciences, The University of Poonch, Rawalakot, Azad Jammu & Kashmir, Pakistan 3Department of Horticulture, Faculty of Agriculture, The University of Poonch, Rawalakot, Azad Jammu & Kashmir, Pakistan 4First Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan 5Research and Development Department, Herbion Pakistan (Pvt.) Limited, Korangi Industrial Area, Karachi, Pakistan 6University College of Agriculture, University of Sargodha, Pakistan

Abstract: HIV or AIDS is a major threat for humanity in the world especially in developing countries. The causative factor of the syndrome is HIV, which infects and destroys one of the cellular components of the immune system, the T cells, causing deficiency in the immunological surveillance and ultimately leading to AIDS. According to WHO, around 35 million people were living with HIV in 2013 and since the start of epidemic 39 million people have died due to AIDS. Center for disease control and prevention estimated in 2014 that 1,201,100 people aged 13 and above were suffering from HIV infection Worldwide. The most effective approach is the highly active antiretroviral therapy (HAART) containing the combined use of drugs having different mechanisms of action. However, complete eradication of HIV from the body does not occur by HAART, but it lead to long term toxicity occurs and emerges as drug resistant. Despite the recent development of various new antiretroviral compounds, there is still a need to develop need to search for new alternatives which are equally efficient and less expensive as compared to the contemporary treatment available. This review provides an overview and a summary of medicines for HIV infection and summarized the efficacy and medicinal use of different used in the treatment of HIV infection. The objective of this review is to enlighten the recent advances in the exploration of used for treatment of HIV/AIDS.

Keywords: AIDS, medicinal plants, efficacy, literature review.

INTRODUCTION antiretroviral therapy (HAART) containing the combined use of drugs having different mechanisms of action. AIDS is an infectious disease caused by a transmissible Morbidity and mortality of patients with AIDS has infectious agent called human immunodeficiency virus. markedly decreased due to this approach. This approach Studies indicate that AIDS virus has been found in high contains antiretroviral drugs such as protease inhibitors, concentrations only in blood and semen. Other body reverse transcriptase inhibitors and a recently introduced fluids like saliva and tears also show the presence of the fusion inhibitors (Palella et al, 2006). However, complete virus but evidence of spread of infection through these eradication of HIV from the body does not occur by fluids is lacking. The first case of AIDS was recorded in HAART, long term toxicity occurs and eventually drug USA in 1981. The virus of AIDS was discovered by Prof. resistant HIV emerges (Nadembega et al, 2006). Luc Montagnier and his colleagues at the Pasteur institute Therefore there is a need to search for new alternatives, in Paris and they had given the name as lymphadenopathy which are equally efficient and less expensive as associated virus (Papadopulos et al., 2004). Soon compared to the contemporary treatment available. afterwards Dr Robert Gallo and his associates at the Various medicines are being used in HIV treatment. national cancer institute Bethesda USA confirmed the Herbal medicines are gaining popularity due to less side presence of new virus isolated form of AIDS and called it effects and better efficacy that is evident from in vitro and human T lymphocytes III (Gallo, 1997). Later on the in vivo studies conducted on herbal medicines (table 1). present term-human immunodeficiency virus was adopted Various chemical constituents or compounds obtained by international committee in of virus for the from medicinal plants have proven their efficacy and agent responsible for AIDS. AIDS has dramatically safety in the treatment of HIV and related disorders. increased in developing countries over the past few Major pathogens in HIV infections (Parveen et al., decades. The most effective approach is the highly active 1994).

*Corresponding author: e-mail: [email protected] Pak. J. Pharm. Sci., Vol.29, No.4, July 2016, pp.1331-1338 1331 Comprehensive review on treatment of HIV

Bacteria eventually the cells burst releasing the thousands of new Bacteria include penicillium marfenii, mycobacterium viruses in the blood, which infect new white blood cells. avium intracellulare, mycobacterium tuberculosis, This cycle goes on and on, and eventually the immune nocardia, rochalimaea quintana, rhodococcus equi, system of the body is overwhelmed and is no longer salmonella spp, moraxella catarrhalis, haemophilus capable of fighting the infection. The immune system if influenza and streptococcus pneumonia patient is weakened that they develops different Viruses opportunistic diseases like tuberculosis, pneumonia, Viruses include human papilloma virus, papovirus, persistent diarrhea, fever, skin infection ultimately leading cytomegalovirus, varicella virus and herpes simplex. to death of patient (Levy, 1993).

Fungi and yeast Medicinal plants having anti-HIV activity Fungi and yeast include coccidioides immitis, histoplasma lignosa capsulatum, cryptococcus neoformans and candida spp. Family: , Parts used: Aerial parts. Chemical constituents: It contains phenolic compounds, Protozoa ellagitanins, flavonoids, sugar and ascorbic acid. Protozoa include microsporidia spp, isopora belli, Medicinal uses: It is used in viral infection and malaria. cryptosporidium parvum, toxoplasma gondii, Pharmacological activity: It is antiviral and anti-malarial. pneumocystis carinii. Study: Bedoya et al, has reported that extracts of Tuberaria lignosa exhibits anti-HIV activity in an in vitro Risk factors MTT assay. A study was conducted to screen medicinal Followings are the important factors increasing the risk of plants for their anti-HIV activity. Tuberaria lignosa was HIV infection such sexually transmitted infections, found effective in HIV (Bedoya et al, 2001). Further menstruation, non-circumcised, increased number of extract was fractionated and constituents were isolated sexual partners, sharing needles, prostitutes and and their anti-HIV activity was tested in vitro. The intravenous use (Narain et al., 1994). compound isolated was ellagitannin enriched fraction that was isolated first time in this . Martino et al reported Signs and symptoms that ellgitannin is HIV-1 reverse transcriptase inhibitor Major clinical features are fever, fatigue, erythematous (Martino et al., 2004). This ellagitannin enriched fraction maculopapular rash mainly over trunk, opportunistic showed anti-HIV activity in MT-2 infected cells. infections such as oropharyngeal candidiasis, Ellagitannin enriched fraction was effective with an IC50 pneumocystis carinii pneumonia, neurological value of 2.33mug/ml. ellagitannin enriched fraction presentation manifesting as aseptic meningitis, exhibited anti-HIV activity that is mediated by CD4 encephalitis, myelitis, polyneuritis, mucosal ulceration down-regulation and CD4 is the main receptor for entry (mouth, genital), headache, arthralgia, myalgia and of HIV. Ellagitannin enriched fraction does not affect the pharyngitis with cervical lymphadenitis (Portillo et al., CXCR4 and CCR5 receptors. This study indicates that 2007) ellagitannin-enriched fraction is able to inhibit R5 and X4 infections. Furthermore, it also inhibits NL4.3-Luc Pathology replication at dose of 12,5mg/ml concentration (Bedoya et HIV is a retrovirus, which characteristically targets the al, 2010). cells, which have CD4 protein on their surface, so it attacks macrophages and T helper cells. These cells are concerned with cell mediated immunity. Due to this attack Family: Asteraceae, Parts used: Flowers and . the number of CD4 carrying cells is reduced. Increasing Chemical constituents: It contains triterpenoid esters, immune suppression is recognized by decreasing CD4 resins, essential oil, carotenoids, lutein, saponin, lymphocytes count. If CD4 count falls below 500 it is an flavoxanthin, beta-carotene, auroxanthin and zeaxanthin. indication of active disease. A count below 200 is of poor Medicinal uses: It is used in wounds, scalds, burns, prognostic value. The HIV actually goes inside the white bruises, eczema, varicose veins, gastritis, duodenal ulcers, blood cells and lies quietly. After about 5-10 years, the colitis, indigestion, constipation, gallbladder problems, HIV virus enters the cell to start making viral proteins or thrush and dysmenorrhea. Pharmacological activity: It is proviral DNA by reverse transcriptase enzyme. This then anti-inflammatory, astringent, antiseptic, antifungal, enters the nucleus of CD4 lymphocytes and gets cholagogue and emmenagogue. Study: A study conducted integrated into cell DNA, thus hijacking the human cell, in 1978 indicated that chloroform extract of Calendula which is converted into a factory and starts manufacturing officinalis has HIV replication inhibitory activity in new HIV particles. These enter new CD4 cells and acutely infected lymphocytic MOLT-4 cells in vitro with destroy them and ultimately CD4 cell count decreases to IC50 of 0.4mg/ml (May and Willuhn, 1978). Kalvatchev less than 200/mm. These results in the formation of huge et al has reported the anti-HIV activity of extracts from number of viral particles inside the white cells and Calendula officinalis flowers. Flowers of this plant were 1332 Pak. J. Pharm. Sci., Vol.29, No.4, July 2016, pp.1331-1338 Muhammad Daniyal et al used for experiment. Extract was tested for its efficacy to spectrum data was used to determine the structures and inhibit replication of human immunodeficiency virus type stereochemistry. Lancilactone inhibited replication of 1 (HIV-1). Organic and aqueous extract was used for HIV. EC50 value of this triterpne was 1.4 microg/mL study. Both were non-toxic to human lymphocytic Molt-4 (Chen et al, 1999). cells. Potent antiviral activity was exhibited by organic extract in an in vitro MTT/tetrazolium-based assay. When Symplocos setchuenensis organic extract was administered at dose of Family: Symplocaceae, Parts used: Bark. Study: Ishida et 500microgram/ ml, uninfected Molt-4 cells were al has reported the anti-AIDS agents, anti-HIV activity of protected from infection for up to 24 hours from fusion harman, an anti-HIV principle from Symplocos and subsequent death. This study indicated that organic setchuensis and its derivatives. A study conducted by extract from Calendula officinalis flowers has anti-HIV-1 Ishida et al (2001)., Symplocos setchuensis has two reverse transcription (RT) activity (Kalvatchev et al, compounds named Matairesinol (1) and harman (5). 1997). Calendula officinalis is topically used in These compounds were found active against replication of exfoliative cheilitis that is associated with candida HIV in H9 lymphocyte cells. Further anti-HIV activity of infection in HIV positive patients (Lucia et al., 2009). 28 derivatives of 5 showed that compound 19 has anti- HIV activity. EC50 of this compound was 0.037 micM and Palicourea condensate therapeutic index values was 210 micM (Ishida et al, Family: Rubiaceae, Part used: Leaves. Medicinal uses: It 2001). There is significant difference when compared to is used in tumors and HIV. Pharmacologic activity: It is EC50 of Symplocos setchuenensis to EC50 of uterotonic and cytotoxic. Study: Bokesch et al, has contemporary medicine. EC50 of Symplocos reported a novel anti-HIV macrocyclic peptide from setchuenensis is different from EC50 reported by Wei et Palicourea condensate. This macrocycylic peptide al., 2014; in which, EC50 of romidepsin, vorinostat and contains thirty-seven amino acids. This peptide was panobinostat was 4.5Nm, 3.950 and 10nM respectively isolated from organic extract of this plant. Palicourein is (Wei et al., 2014). EC50 of Symplocos setchuenensis is further evaluated for its efficacy to inhibit HIV. It was also different from EC50 reported by Pirounaki et al in found that it is able to inhibit the in vitro cytopathic which EC50 of zidovudine, nevirapine and indivinavir effects of HIV-1RF infection of CEM-SS cells. Although was 0.14 microM, 0.33 microM and 0.02 microM the mechanism of action is not yet understood, however, respectively (Pirounaki et al., 2000). Keeping in view the the plausibly suggesting reverse transcriptase as a all discussed findings, it is suggested that Symplocos potential mechanism of action. It was active at EC50 setchuenensis can be used for treatment of HIV infection value of 0.1 microM and an IC50 value of 1.5 microM as an alternative drug. (Bokesch et al, 2001). Acer okamotoanum Ancistrocladus korupensis Family: Sapindaceae, Parts used: Leaves. Chemical Family: Ancistrocladaceae. Parts used: Leaves. Chemical constituents: It contains flavones glycoside gallate and constituents: It contains naphthyloisoquinoline alkaloid quercetin. Medicinal uses: It is used in HIV. dimer and michellamine B. Medicinal uses: It is used in Pharmacological activity: It has anti-HIV activity. Study: AIDS, measles and dysentery. Pharmacological activity: It Kim et al has reported a new flavonol glycoside gallate is antimalarial and anti-HIV. Study: Boyd et al, has ester from Acer okamotoanum and its inhibitory activity reported the anti-HIV michellamines from Ancistrocladus against human immunodeficiency virus-1 (HIV-1) korupensis. Michellamin B from this plant inhibits HIV integrase. Ethyl acetate extract of this plant was prepared induced cell killing and viral replication in a variety of that was further fractionated. New compounds i.e. human cell lines. This compound was found active against phenolic compounds and flavonol glycosides were clinical strains of HIV-1 (G910-6) and A17. It was also identified from this plant. Spectrometric methods were effective against HIV-2. (Boyd et al, 1994). used to determine the structure of the new compound. The most active compounds were Quercetin 3-O-(2"-galloyl)- Kadsura lancilimba alpha-L-arabinopyranoside (6) and 1. Significant anti- Family: Schizandraceae, Parts used: Stems and roots. HIV integrase activity was exhibited by these compounds Chemical constituents: It contains triterpene and (Kim et al, 1998). Flavan-3-ol inhibits HIV and its lancilactone. Medicinal uses: It is used in HIV. efficacy is better than flavonones and flavones (Gerdin Pharmacological activity: It is anti-HIV. Study: Chen et al and Srensso, 1983). HIV infection and replication is has reported the novel anti-HIV lancilactone C and related inhibited by baicalin, a flavonoid found in Scutellaria triterpenes from Kadsura lancilimba. Root and stem of baicalensis and other flavonoids such as hinokiflavone this plant is used to treat HIV and other associate and robustaflavone also inhibit HIV-1 reverse disorders. Lancilactone C and related triterpenes are transcriptase (Cushnie and Lamb, 2005). Another study found in Kadsura lancilimba. These triterpenes were indicated that flavones o glycoside inhibit HIV reverse isolated from root and stem of this plant. Mass and NMR transcriptase and prevent entry of HIV-1 into cells Pak. J. Pharm. Sci., Vol.29, No.4, July 2016, pp.1331-1338 1333 Comprehensive review on treatment of HIV possessing chemokines corecepters and expressing CD4 isolated from this plant and were tested for anti-HIV RT (Li et al, 2000). HIV-1 protease is inhibited by flavonoids activity. Study indicated that robustaflavone and such as robinetin and demethylated gardenin A (Cushnie hinokiflavone have similar activity against HIV-1 reverse and Lamb, 2005). Another study showed that flavonoids transcriptase (RT). Amentoflavone, agathisflavone, apigenin, acacetin and chrysin inhibit activation of HIV-1 morelloflavonem GB-1a and GB-2a exhibited moderate via inhibition of viral transcription (Critchfield et al, activity against HIV-1 RT. Anti-HIV activity was also 1996). observed by Morelloflavone. Other compounds were very week or have no activity against HIV-1 in human Fraxinus sieboldiana lymphocytes (Lin et al, 1997). Family: Oleaceae, Parts used: Bark. Chemical constituents: It contains calceolarioside, hydroxy- Ancistrocladus abbreviatus coumarins, phenylethanoid glycosides, lignin and Family: Ancistrocladaceae, Chemical constituents: It esculetin. Medicinal uses: It is used in cardiovascular contains naphthylisoquinoline. Study: Manfredi et al disorders, HIV and colon cancer. Pharmacological reported that novel alkaloids from the tropical plant activity: It is anti-oxidant and anti-HIV. Study: Kim et al Ancistrocladus abbreviatus inhibit cell killing by HIV-1 has reported the HIV gp41-binding phenolic components and HIV-2 (Manfredi et al, 1991). from Fraxinus sieboldiana. Fraxinus sieboldiana contain phenylethanoid glycosides and hydroxycoumarins. These Crataegus pinnatifida compounds were isolated using chromatographic Family: Rosaceae, Parts used: Fruit and leaves. Chemical fractionation. Three phenylethanoid glycosides, four constituents: It contains sorbitol, diethylamine hydroxycoumarins and one lignin were identified and hydrochloride, rhamnosylvitexin, hyperin, quercetin and isolated. Isolation was done by using n-butyl alcohol malic acid. Medicinal uses: It is used in skin cancer. fraction. Esculetin and calceolarioside B exhibited Pharmacological activity: It is anti-thrombotic. Study: moderate binding affinity on HIV gp41 (Kim et al, 2002). Min et al reported the inhibitory effect of triterpenes from Hydroxycoumarin has HIV-1 protease inhibitor activity Crataegus pinatifida on HIV-1 protease. Concentraion of (Kirkiacharian et al., 2002). Therefore Fraxinus extract was 100 micrograms/ml. Furthermore two new sieboldiana could assist in the prevention and/or compounds were isolated from this plant. Structure of treatment of HIV. these compounds was similar to uvaol and ursolic acid. This similarity was found on spectral data. These two Celastrus hindsii compounds were active anti-HIV-1 protease. IC50 value of Family: Celastraceae, Parts used: Leaves. Chemical uvaol was 5.5 and IC50 of ursolic acid was 8.0 microM constituents: It contains maytenfolone and celasdin-B. (Min et al, 1999). Medicinal uses: It is used in tumor and HIV. Pharmacological activity: It has anti-HIV activity. Study: Punica granatum Kuo et al has reported the antitumour and anti-HIV Family: Lythraceae, Parts used: Flowers, seeds, pericarb, triterpenoids from Celastrus hindsii. Celatrus hindsii bark and juice. Chemical constituents: It contains contains triterpene compounds. Various compounds were isopelletierine, pectin, fiber, vitamin C, sulphur, isolated from this plant and one compound named potassium, magnesium and carbohydrates. Medicinal Maytenfolone-A was further evaluated for its efficacy. uses: It is used in carcinoma of prostate, diabetes mellitus, Cytotoxicty against hepatoma and nasopharynx lymphoma and rhinovirus infection. Pharmacological carcinoma was demonstrated. ED50 of compound was 2.3 activity: It is hypoglycemic, anti-cancer and anti-viral microgram/ml against hepatoma. ED50 of compound was agent. Study: Neurath et al reported that Punica granatum 308 micrograms/ml against nasopharynx carcinoma. provides an HIV-1 entry inhibitor and candidate topical Celasdin-B was able to inhibit anti-HIV replication microbicide. In a study, inhibitory activity of fruit juice activity in H9 lymphocyte cells. EC50 was 0.8microgram was investigated against HIV-1 IIIB. CD4 and CXCR4 ml-1 (Kuo et al, 1997). were used as cell receptors. This study indicated that possibility of producing an anti-HIV-1 microbicide from Rhus succedanea Punica granatum (Neurath et al, 2004). Family: Anacardiaceae, Part used: Drupes. Chemical constituents: It contains morelloflavone, bioflavonoid, Garcinia speciosa obustaflavone, hinokiflavone, agathisflavone and Family: Garcinia speciosa, Parts used: Bark. Chemical amentoflavone. Medicinal uses: It is used in cancer, constituents: It contains digeranyl benzophenone, degenerative disorders and viral infections. triterpenes, lanostanes and friedolanostane. Medicinal Pharmacological activity: It is anti-oxidant, cytotoxic and uses: It is used in helicobacter pylori infection and anti-HIV. Study: Lin et al reported the in vitro anti-HIV hyperlipidemia. Pharmacological activity: It is activity of bioflavonoid isolated from Rhus succedanea antihelicobacter, antiobesity and anti-HIV. Study: and Garcinia multiflora. Various compounds were Rukachaisirikul reported the anti-HIV-1 protostane 1334 Pak. J. Pharm. Sci., Vol.29, No.4, July 2016, pp.1331-1338 Muhammad Daniyal et al

Table 1: Medicinal plants having anti-HIV activity

Mechanism IC50/ LD50 Plant Family Part used Functions References of action /EC50/ IC50 (9±4.6 Leaves, Anti-HIV, Reverse µg/ml) and, Gyuris et stem and gastroprotective, transcriptase hirta L Therapeutic al, 2009 flowers antimalarial inhibitor index (19) El- Ganoderma Anti-HIV, Anti-HIV-1 LD50 Ganodermataceae Spores Mekkawy lucidum immunosuppressant protease (0.05 microM) et al, 1998 Inhibits HIV EC50 (1.7 Xanthoceras reverse mg/ml) and Kashiwada, Sapindaceae Wood Anti-HIV sorbifolia transcriptase IC50 (21.8 1998 and integrase mg/ml) Maprounea Reverse Pengsuparp africana Euphorbiaceae Roots Anti-HIV transcriptase IC50 (3.7 mM) et al., 1994 Muell. inhibitor Anti-HIV, anti- EC50 Arnebia Inhibits HIV Kashiwada Boraginaceae Roots inflammatory, (2.6 euchroma replication et al, 1995 antimicrobial micrograms/ml) Phyllanthus Whole Inhibits HIV EC50 (20.98 Ogata et al. Phyllanthaceae Anti-HIV niruri plant replication microgmL) 1992 triterpenes and digeranylbenzophenone from trunk bark reported the HIV-1 protease and HIV-1 integrase and stems of Garcinia speciosa. Garciosaterpenes, inhibitory substances from Eclipta prostrata. Six digeranylbenzophenone and garciosaphenone are found in compounds were isolated from this plant. A compound this plant. Garciosaterpenes and garciosaphenone found namely Wedelolactone was found most active against effective in inhibiting the HIV-1 reverse transcriptase. HIV-1 integrase. Another compound namely terthiophene This study showed the anti-HIV-1 activities of this plant was found inactive. This study validates the use of thus (Rukachaisirikul, 2003). drug in HIV patients (Tewtrakul et al, 2007).

Pinus parviflora Euphorbia hirta L. Family: Pinaceae, Parts used: Cones. Chemical Family: Euphorbiaceae. Parts used: Stems, roots, latex constituents: It contains uronic acid, glucose, galactose and seeds. Chemical constituents: It contains phytosterol, and mannose. Medicinal uses: It is used in tumor and alkanes, flavonoids, polyphenols, tannins and triterpenes. bacterial infections. Pharmacological activity: It is anti- Medicinal uses: It is used in colic, dysentery, cough, microbial and anti-tumor. Study: Tamura et al reported bronchial infection, asthma, eczema and warts. that soluble factor induced by an extract from Pinus Pharmacological activity: It is antispasmodic, parviflora can inhibit the replication of human antibacterial and antiasthmatic. Study: Gyuris et al immunodeficiency virus in vitro. This extract (PC6) was reported activity of extracts of Euphorbia hirta L. against obtained from cones of Pinus parviflora. This extract HIV-1, HIV-2 and SIVmac251 (Gyuris et al, 2009). induces the he human T-cell line CEM that in turn causes formation of pepsin-sensitive soluble factor. Replication Geum japonicum of the type 1 human immunodeficiency virus (HIV-1) is Family: Rosaceae, Parts used: Whole plant. Chemical inhibited. Study showed that PC6 induces anti-HIV-1 constituents: It contains triterpenoid compounds such as factor induced (Tamura et al, 1991). 19α-hydroxyasiatic acid. Medicinal uses: It is used in diarrhea, heart problems and cancerous diseases. Eclipta prostrata Pharmacological activity: It is cardioprotective and anti- Family: Asteraceae, Parts used: Leaves, roots and aerial viral. Study: Xu et al has reported the anti-HIV triterpene parts. Chemical constituents: It contains ascorbic acid, acids from Geum japonicum. Methanolic extract of this oleanolic acid, ursolic acid, alpha amyrin, benzoic acid, plant was used for experimental study. HIV-1 protease lacceroic acid, stearic acid, daucosterol, alkaloids and was inhibited by the use of methanol extract from the saponins. Medicinal uses: It is used in snakebite, jaundice, whole plant of Geum japonicum. Various compounds bacterial infection, asthma, tuberculosis, anemia, skin were isolated from these plants that were further disorders, itching, hyperlipidemia and obesity. investigated for their Ant-HIV activity. This plant contains Pharmacological activity: It is antibacterial, tormentic acid and other associated 4 comounds. A new hepatoprotective and antiasthmatic. Study: Tewtrakul et al triterpene acid from this plant was isolated. All Pak. J. Pharm. Sci., Vol.29, No.4, July 2016, pp.1331-1338 1335 Comprehensive review on treatment of HIV compounds were tested. Ursolic acid and maslinic acid Smilax glabra was found potent anti-HIV-1 protease (Xu et al, 1996). Family: Smilacaceae, Parts used: Root. Chemical constituents: It contains smiglabrol and smiglactone. Prunella vulgaris Medicinal uses: It is used in diabetes mellitus, Family: Lamiaceae, Part used: Whole herb. Chemical inflammation and cancer. Pharmacological activity: It is constituents: It contains cellulose, sugar, tannin and anti-proliferative, anti-viral, immunomodulant and volatile oil. Medicinal uses: It is used in sore throat, antihyperglycemic. Study: It has been studied that hemorrhoids, wounds and headache. Pharmacological smilaxin from Smilax glabra rhizomes attenuate the activity: It is astringent and wound healer. Study: Yao et activity of HIV-1-reverse transcriptase with an IC50 of al has reported the mechanism of inhibition of HIV-1 5.6µM (Chu, 2006) infection in vitro by purified extract of Prunella vulgaris. Crude extract of this plant was used for study. Cytotoxic Withania somnifera and anti-HIV activity was tested in several tissue culture Family: Solanaceae, Parts used: Root bark, berry, flower, lines. HIV replication was inhibited significantly by use fruit, leaves, seeds, tubers and root. Chemical of Prunella vulgaris extract. Low toxicity effect was constituents: It contains tannin, withaferine A, withanine observed by use of this plant extract. Furthermore, active and somniferin. Medicinal uses: It is used in rheumatism, constituents were isolated from this plant. HIV replication lumbar pain, ulcers, chest pain, loss of memory, syphilis, was inhibited by the purified extract. Extract was active at inflammation, bronchitis, tumor and eye sores. different dose levels 6, 30 and 12.5 micrograms/ml. HIV Pharmacological activity: It is anti-inflammatory, replication was not prevented when extract was antihyperuricemic, antigout, aphrodisiac, alterative, administered to uninfected cells prior to infection. anthelmintic, hypnotic, diuretic, deobstruent, narcotic, Infectiveness was dramatically reduced when HIV-1 was nervine tonic and emmenagogue. Study: In one study, pre-incubated with the purified extract. Transmission of Ocimum sanctum Linn., Withania somnifera Dunal, HIV-1 from cell to cell was blocked by the purified Tinospora cordifolia were screened for anti-HIV activity. extract. Syncytium synthesis was prevented by this All plants caused interference with the gp120/CD4 extract. HIV-1 and purified gp 120 was not able to bind to interaction. Ocimum sanctum and Tinospora cordifolia CD4 in presence of extract. When analyzed on PCR, there inhibited reverse transcriptase of virus and contributed to was absence of HIV-1 proviral DNA in cells that were the overall anti-viral activity in vitro (Anuya et al, 2010) exposed to virus in the presence of the extract. This study indicated that extract of this plant is able to prevent HIV Soya bean infection of susceptible cells by a mechanism that blocks Family: Fabaceae, Parts used: Seeds Chemical attachment of virus to the CD4 receptor (Yao et al, 1992). constituents: It contains oleic acid, linolic acid, linolenic acid, stearic acid and palmitic acid. Medicinal uses: It is Rosa damascena used in arthritis, infertility, edema and jaundice. Family: Rosaceae, Parts used: Flower buds, stamens and Pharmacological activity: It is anti-diabetic and memory aqua of flowers. Chemical constituents: It contains enhancer. Mechanism: Xiu et al reported the antitumor quercitannic acid, volatile oil, malic acid, tartaric acid, and HIV-1 reverse transcriptase inhibitor activity of a gallic acid, qercitrin and tannic acid. Medicinal uses: It is Hemagglutinin and a Protease Inhibitor from Mini-Black used in burning sensation, leprosy, intestinal affections, Soybean (Xiu et al, 2011). inflammations, chronic fever, stomatitis, toothache and headache. Pharmacological activity: It is astringent, anti- CONCLUSION inflammatory, appetizer, expectorant, cardiotonic and aphrodisiac. Study: A study was conducted to investigate A variety of medicinal compounds obtained from various the in vitro efficacy of Rosa damascena to treat HIV. In medicinal plants have been utilized to cure, prevent or this study, various compounds were purified from the ameliorate HIV/AIDS infections. The clinical trials methanol extract of Rosa damascena and were evaluated conducted on different components of medicinal plant on C8166 human T lymphoblastoid cells infected with origin have shown their effectiveness to combat the HIV HIV-1MN and H9 human T-cell lymphoma cells malaise and have shown no adverse effects. The synthetic chronically infected with HIV-1IIIB. Kaempferol and drugs used for the treatment of HIV are costly and exhibit other related compounds exhibited significant activity side effects or adverse drug reaction as well as possibility against HIV infection of C8166 cells. Quercetin 2 was of drug resistance. Medicinal plant chemical constituents effective against HIV. Rosa damascena has anti-HIV could be viable option to explore these promising activity due to the synergistic effects of different naturally derived anti-HIV compounds so that the results compounds acting additively against different stages of and experiences with many of the anti-HIV natural virus replication. Mahmood et al reported the anti-HIV products will inspire and motivate even more researchers activity and mechanisms of action of pure com-pounds to explore alternative way of treatment of HIV. 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