**Acknowledgements**

remedies derived from the ancient medical science forms of different countries are the most widely sought after modality of complementary or alternative therapies. The various mind and body techniques include spirituality, meditation, yoga and other body manipulatory

Observations across the globe reveal that 30 - 90% of the HIV infected patients seek for complementary or alternative therapies of which, majority are females and educated individ‐ uals [169, 170]. The usefulness of these therapies is controversial. Spiritual methods such as prayer, faith healing and meditation are found to improve the psychological state by helping to overcome anxiety, depression and stress thereby providing a feeling of well being [171]. The compound IGM-1, obtained from herbs used in traditional medicine was observed to alleviate the symptoms of HIV infection but did not have any effect in reduction of viremia or improving the immune status. Many of the other Chinese herbal medicines tested were found to be unsatisfactory in altering the viral and immune parameters [172]. To much despair, several studies have highlighted the deleterious effects of complementary and alternative medicines. Recent reports indicate that patients on concurrent complementary therapy have reduced adherence rate to conventional anti-retroviral therapeutic regimens [173]. Homeopathy, a traditional health system has been proven ineffective for the treatment of HIV infection and has been disregarded by the WHO [174]. Herbal preparations containing St. John's Wort and those containing garlic extracts reduce the therapeutic levels of conventional anti-retrovirals. Apart from reducing the efficacy, many other herbal preparations have also been observed to

Despite these assumptions, complementary and alternative therapies cannot be totally overlooked. This is due to the fact that natural compounds with antiretroviral property such as indirubin monoxime and tanshinone II A have been isolated from herbal medications [80, 81]. Meta analyses on the efficacy of herbal preparations have yielded only inconclusive results but not ineffective [172, 175]. Hence rigorous clinical trials including large study population are required to refute or accept the potential benefits of these therapeutic modalities. National Centre for Complementary and Alternative medicine, a division of the National Institute of Health, USA is an organization dedicated for research in alternative and complementary

The HAART has played its crucial role in curtailing the HIV pandemic so far. However, its inability to eliminate the infection and the rise of resistant mutants is a fundamental challenge. This has initiated the frantic search for novel compounds and strategies to counteract HIV. Desperate measures have resulted in the discovery of a plethora of anti-retroviral compounds and strategies, but none could be unanimously agreed upon as completely reliable. The much hyped functional cure concept has taken a big blow with the occurrence of rebound viremia in the Mississippi baby. Moreso, studies to replicate the sterilizing cure of the Berlin patient have provided disappointing results. Despite the development of various novel antiviral

medicines and thus provides funding to various studies in this field [167].

procedures, acupuncture and energy therapies [168].

236 Trends in Basic and Therapeutic Options in HIV Infection - Towards a Functional Cure

increase the HAART related side effects [169].

**10. Conclusions**

This work was supported by NUS SoM Start-up Grant (R-182-000- 160-733, R-182-000-160 -133) to N.Y.
