investigators were not blinded so open to systematic bias. To say if themeasurements were valid, reliable, and reproducible, one might need a largergroup. The paper could point to possible use of KRG, but is difficult to concludewithout more rigorous trials.Hypericum perforatum (HP); St John's WortHypericum perforatum (HP); St John’s WortHypericin or HP is taken commonly by HIV-infected persons (Kassler et al 1991).Hypericin has activity against many HIV in vitro Hudson et al 1991). In 1989researchers found that two extracts of HP had anti-HIV activity in lab experimentswith cells and viruses. Since hypericin is known to exhibit a similar inhibitoryproperty, it is likely to be one of the active constituents of St Johns wort(Taher et al 2002). Hypericin appears to inactivate free virions and interferewith steps in the replicative cycle (Hudson 1991). Hypericin and pseudohypericindisplay an extremely effective antiviral activity when administered to mice afterretroviral infection (Muerelo et al 1988). It was found that relatively smalldoses of hypericin or pseudohypericin 10-50ug per mouse can prolong survival ofHIV infected mice. When the compounds interact with the infection particlesshortly after in vivo administration, disease is completely prevented. Thecompounds can cross the blood-brain barrier (Meruela et al 1988). Initial studieslooked promising (James 1989).An uncontrolled study of 26 pt self-administering Hypericum containing herbalextract (Cooper and James 1990) concomitant, used AZT, and other treatment waspermitted. All patients were HIV positive, at various stages of the disease, andwere taking approximately 1 mg total hypericin per day. They received baseline and4 monthly checks, including physical examinations, T-cell subsets and p24 antigen.Toxicity was limited to mild reversible liver enzyme elevation in 5 patients, withlevels returning to baseline after 1 month without Hypericum. At the end of the 4-month study, p24 antigenaemia disappeared in 2 of 6 initially positive patients,both also using AZT. CD4 cell changes differed, depending on AZT usage, in thesubgroup of 10 pt who had never taken AZT, none had developed AIDs, the mean CD4count increased 13% from the base line after 1 month of Hypericum and maintainedthis increase for 4 months. These increases were not statistically significant. Bycontrast however, in those using Hypericum and AZT throughout the study, CD4counts fell significantly after initial mild rise.Details of the patients are minimal and there was no control group; size samplewas small and duration short. So, again, a study might not have any significance,however this is the first pointer towards that hp might interfere with theanitiviral AZT and as a consequence lower CD4 count.A study was carried out to assess the toxicity and possible anti-HIV activity ofhypericin; there was no CD4 count criteria for entry (Fumer et al 1991). Fourdifferent daily dosage levels of hypericin were administered (0.5mg, 2mg, 4mg,8mg) to cohorts, often HIV-infected men, all HIV positive, no details of whatstage of disease, for a period of 12 weeks. No indication is given on the baselinedifferences between the different groups. Possibly observed toxicities includedmild diarrhoea and indigestion, and infrequent itchy rash, and fatigue ordepression. An idiosyncratic, reversible elevation of hepatic transaminases wasalso observed. No early, marked anti-HIV activity was found. The authors concludedthat at doses of 2mg per day given to HIV infected individuals, hypericin appearsto be safe for the majority of subjects observed so far (Moraleda et al 1993).Duration of treatment was 12 weeks, which might be too short to notice anybeneficial effects. However the conclusion that 2 mg was a safe dose for themajority of patients is important to look at.