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Li J, Shen C, Liu ZW, Pu FL, Cao SH, Zhang Y, Han XF, Yuan P, Duan SL, Jiang F, Liu JP. Chinese herbal medicine for patients living with HIV in Guangxi province, China: A propensity score matching analysis of real-world data. PLoS One 2024; 19:e0304332. [PMID: 39240822 DOI: 10.1371/journal.pone.0304332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/06/2024] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND From 2004 onwards, the Chinese government has freely offered complimentary Chinese herbal medicine (CHM) to Chinese HIV/AIDS patients, alongside the prescribed first line therapy of highly active antiretroviral therapy (HAART). Thus, we aimed to explore the effectiveness and safety of CHM for patients with HIV/AIDS. METHODS The data from the Guangxi pilot database and antiviral treatment sites database have been respectively developed into two datasets in this prospective cohort real-world study, the CHM combined HAART group (the integrated group) and the HAART group. A 1:1 propensity score matching (PSM) was performed and the longitudinal data were analyzed using a generalized estimating equation (GEE) model with an autocorrelation matrix and log link function attached to the Gamma distribution. RESULTS A final sample of 629 patients, 455 and 174 in the integrated group and HAART group respectively, were obtained from the full dataset. As covariates for PSM, gender, age, baseline CD4+ and CD4+/ CD8+ were assessed based on the results of the logistic regression analyses. Following PSM, 166 pairs from the full dataset were matched successfully, with 98 pairs in the baseline CD4+ > 200 subgroup, and 55 pairs in the baseline CD4+ ≤ 200 subgroup. In the full dataset, HAART group achieved higher CD4+ count (OR = 1.119, 95%CI [1.018, 1.230]) and CD4+/CD8+ ratio (OR = 1.168, 95%CI [1.045, 1.305]) than the integrated group, so did in the CD4+ > 200 subgroup. For the CD4+ ≤ 200 subgroup, the CD4+ (OR = 0.825, 95%CI [0.694, 0.980]) and CD4+/CD8+ (OR = 0.826, 95%CI [0.684, 0.997]) of the integrated group were higher than those of the HAART group. The safety outcomes showed that there were no significant differences in BUN, ALT and AST levels between the groups but Cr showed significantly higher levels in HAART groups of all three datasets. CONCLUSIONS Compared to HAART alone, CHMs combined with HAART had better effects in improving the immune function of HIV/AIDS in patients with baseline CD4+ count ≤ 200. The results of the two subgroups are in opposite directions, and chance does not explain the apparent subgroup effect. A study with larger sample size and longer follow-up period is warranted in order to increase study credibility.
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Affiliation(s)
- Jing Li
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Beijing Key Laboratory of the Innovative Development of Functional Staple and the Nutritional Intervention for Chronic Disease, China National Research Institute of Food & Fermentation Industries Co,. Ltd, Beijing, China
| | - Chen Shen
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhen-Wei Liu
- AIDS Centre, Ruikang Hospital, Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Feng-Lan Pu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Huan Cao
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Zhang
- Center for Disease Control and Prevention of Minhang District, Shanghai, China
| | - Xiao-Feng Han
- Beijing Key Laboratory of the Innovative Development of Functional Staple and the Nutritional Intervention for Chronic Disease, China National Research Institute of Food & Fermentation Industries Co,. Ltd, Beijing, China
| | - Peng Yuan
- Beijing Key Laboratory of the Innovative Development of Functional Staple and the Nutritional Intervention for Chronic Disease, China National Research Institute of Food & Fermentation Industries Co,. Ltd, Beijing, China
| | - Sheng-Lin Duan
- Beijing Key Laboratory of the Innovative Development of Functional Staple and the Nutritional Intervention for Chronic Disease, China National Research Institute of Food & Fermentation Industries Co,. Ltd, Beijing, China
| | - Feng Jiang
- AIDS Centre, Ruikang Hospital, Guangxi University of Traditional Chinese Medicine, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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2
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Shahrajabian MH, Sun W. The Importance of Traditional Chinese Medicine in the Intervention and Treatment of HIV while Considering its Safety and Efficacy. Curr HIV Res 2023; 21:331-346. [PMID: 38047360 DOI: 10.2174/011570162x271199231128092621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 12/05/2023]
Abstract
Natural products have been considered a potential resource for the development of novel therapeutic agents, since time immemorial. It is an opportunity to discover cost-effective and safe drugs at the earliest, with the goal to hit specific targets in the HIV life cycle. Natural products with inhibitory activity against human immunodeficiency virus are terpenes, coumarins, flavonoids, curcumin, proteins, such as lectins, laccases, bromotyrosines, and ribosome-inactivating proteins. Terpenes inhibit virus fusion, lectins and flavonoids have an inhibitory impact on viral binding, curcumin and flavonoids inhibit viral DNA integration. The most important medicinal plants which have been used in traditional Chinese medicinal sciences with anti-HIV properties are Convallaria majalis, Digitalis lanata, Cassia fistula, Croton macrostachyus, Dodonaea angustifolia, Ganoderma lucidum, Trametes versicolor, Coriolus versicolor, Cordyceps sinensis, Gardenia jasminoides, Morus alba, Scutellaria baicalensis, Ophiopogon japonicus, Platycodon grandiflorus, Fritillaria thunbergii, Anemarrhena asphodeloides, Trichosanthes kirilowii, Citrus reticulata, Glycyrrhiza uralensis, Rheum officinale, Poria cocos, Rheum palmatum, Astragalus membranaceus, Morinda citrifolia, Potentilla kleiniana, Artemisia capillaris, Sargassum fusiforme, Piperis longi fructus, Stellera chamaejasme, Curcumae rhizoma, Dalbergia odorifera lignum, Arisaematis Rhizoma preparatum, and Phellodendron amurense. The information provided is gathered from randomized control experiments, review articles, and analytical studies and observations, which are obtained from different literature sources, such as Scopus, Google Scholar, PubMed, and Science Direct from July 2000 to August 2023. The aim of this review article is to survey and introduce important medicinal plants and herbs that have been used for the treatment of HIV, especially the medicinal plants that are common in traditional Chinese medicine, as research to date is limited, and more evidence is required to confirm TCM,s efficacy.
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Affiliation(s)
| | - Wenli Sun
- Biotechnology Research Institute, Chinese Academy of Agricultural Sciences, Beijing 100081, China
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3
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Liu Z. Treating older patients with AIDS using Traditional Chinese Medicine Combined with Conventional Western Medicine in China. Aging Dis 2021; 12:1872-1878. [PMID: 34881074 PMCID: PMC8612604 DOI: 10.14336/ad.2021.0925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/25/2021] [Indexed: 12/22/2022] Open
Abstract
Acquired immunodeficiency syndrome (AIDS) is a chronic and incurable disease. People with human immunodeficiency virus (HIV) require lifelong care. Traditional Chinese Medicine (TCM) has played an important role in AIDS treatment since the year 2004. TCM offers many advantages including a rich resource of Chinese herbs, lower cost and fewer side effects. In addition to the widespread use of antiviral therapy, TCM offers unique humanistic care and holistic adjustment of the body system. To date, more and more patients are benefiting from TCM not only in China. In this article, we describe the feasibility of treating AIDS with TCM.
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Affiliation(s)
- Zhibin Liu
- Department of AIDS Treatment and Research Center, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
- Henan Key Laboratory of Viral Diseases Prevention and Treatment of Traditional Chinese Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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4
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Chinese herbal medicine for patients living with HIV in Guangxi province, China: an analysis of two registries. Sci Rep 2019; 9:17444. [PMID: 31767895 PMCID: PMC6877622 DOI: 10.1038/s41598-019-53725-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 10/31/2019] [Indexed: 11/29/2022] Open
Abstract
Anti-Retroviral Therapy (ART) is the recommended first line therapy for patients with HIV. Since 2004, Chinese government has provided free Chinese herbal medicine (CHM) for Chinese HIV/AIDS patients. Data of living patients with HIV from the NFTCMP database and Center for Disease Control (CDC) database during 2003–2016 in Guangxi province was obtained and compared. Patients were divided into 3 groups according to their recorded treatment regimens. A total of 2954 patients with their treatment recorded in the two databases were included for analysis, their median age was 46 years (IQR = 36–59), and 64.63% were male. CHM regimens users had baseline CD4 cell counts (380.11 ± 240.59 cell/μL), approximately 100 cell/μL significantly higher than patients receiving CHM combined with ART regimens or only ART regimens. There was no significant difference in mortality among groups. All three regimens improved patients’ CD4 cell counts. Compared to the sharp improvement in ART group during the first 6 months, CD4 cell counts of patients in CHM group and CHM combined with ART group showed a smooth and steady rise. CD4 cell counts of the combined group remained much lower than ART group in the first 3 years, but overtook ART group in the fourth year.
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Guo H, Wang J, Li Z, Jiang Z, Xu Q, Xu L. Effect of treatment course of comprehensive intervention with Traditional Chinese Medicine on mortality of acquired immunodeficiency syndrome patients treated with combined antiretroviral therapy. J TRADIT CHIN MED 2017; 36:411-7. [PMID: 28459235 DOI: 10.1016/s0254-6272(16)30056-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the effect of a treatment course of comprehensive intervention with
Traditional Chinese Medicine (TCM) on the mortality of patients with acquired immunodeficiency syndrome
(AIDS) treated with combined antiretroviral therapy (cART). METHODS AIDS patients who had taken cART in a national TCM human immunodeficiency virus treatment
trial program (NTCMTP) before 2009 were enrolled in this study and followed for 36 months
from November 2009. Patients enrolled in the NTCMTP in 2004 were taken as the first group, those enrolled
in 2006 as the second group, and those enrolled in 2009 as the third group. Cumulative survival
rates were calculated by the life table method. Survival curves for subgroups were compared by
the log-rank test. Hazard ratios were calculated with a Cox proportional hazards model. RESULTS A total of 1443 AIDS patients were followed for 3 years (4198 person-years). During this
period, 91 (6.3%) patients died and 13 (0.9%) were lost to follow-up. The total mortality rate was 2.17/
100 person-years. The mortality rate of patients enrolled in the NTCMTP in 2004 was 1.49/100 person-
years, which was lower than that of patients enrolled in 2006 (2.23/100 person-years) and 2009
(3.48/100 person-years). After adjusting for other factors, a shorter time of treatment with TCM, male
sex, older age, lower CD4 + T-cell counts, and long-term treatment with cART were risk factors of
mortality. CONCLUSION Long-term treatment with TCM decreased the mortality risk of AIDS patients. Factors
such as being male, older age, CD4 + T-cell counts, and time of treatment with TCM and cART were correlated
with mortality.
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Jin Y, Li Q, Meng X, Xu Q, Yuan J, Li Z, Guo H, Liu Z. Prevalence of anaemia among HIV patients in rural China during the HAART era. Int J STD AIDS 2016; 28:63-68. [PMID: 26672003 DOI: 10.1177/0956462415622866] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of anaemia among HIV patients receiving highly active antiretroviral therapy (HAART) in China has not been extensively studied. The purpose of this study was to estimate the prevalence of anaemia among HIV patients receiving HAART in China. This cross-sectional study was conducted based on data in routine record registers. Factors associated with anaemia were evaluated by logistic regression model. Among the 8632 HIV patients in this analysis, the overall prevalence of anaemia was 39.2%, and the prevalence of mild, moderate, and severe anaemia were 27.2%, 10.8%, and 1.2%, respectively. Anaemia was more prevalence among male, older, little time taken HAART and lower CD4 cell count. Patients taken TCM had lower prevalence of anaemia. The prevalence of anaemia among the HIV patients receiving HAART was high in this study. HIV patients with anaemia who are older and have CD4 cells count lower than 200 cells/mL require more attention. Traditional Chinese medicine may be a potential method to lower the frequency of anaemia.
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Affiliation(s)
- Yantao Jin
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Qingya Li
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Xiangle Meng
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Qianlei Xu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Jun Yuan
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Zhengwei Li
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Huijun Guo
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Zhibin Liu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
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Li Q, Liu Z, Yang J, Guo H, Xu L. [Comment on the intervention of Traditional Chinese Medicine on survival rates of patients living with human immunodeficiency virus and acquired immune deficiency syndrome]. J TRADIT CHIN MED 2016; 36:409-10. [PMID: 27468557 PMCID: PMC7147220 DOI: 10.1016/s0254-6272(16)30055-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Despite many differences between Traditional Chinese Medicine (TCM) and conventional medicine, the use of TCM in the treatment of human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is increasingly recognized and accepted by patients. Recent research findings on the benefits of Chinese herbal medicine on long-term survival in patients with HIV/AIDS are encouraging and hopeful, but inconclusive. More research is needed.
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8
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Liu ZB, Yang JP, Xu LR. Effectiveness and safety of traditional Chinese medicine in treating acquired immune deficiency syndrome: 2004-2014. Infect Dis Poverty 2015; 4:59. [PMID: 26699285 PMCID: PMC4690280 DOI: 10.1186/s40249-015-0093-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 12/16/2015] [Indexed: 11/10/2022] Open
Abstract
Substantial progress has been made in China in using traditional Chinese medicine (TCM) to treat acquired immune deficiency syndrome (AIDS). Our objective was to review the latest developments in TCM treatment of AIDS in China between 2004 and 2014. We reviewed the content of original articles investigating the efficacy and safety of TCM for treating AIDS published in Chinese and English language journals. Relevant references from 2004 to 2014 were found using PubMed and the China National Knowledge Infrastructure Database. We found that TCM has been widely used for treating AIDS and its complications in China. The number of TCM studies has increased, which indicates efficacy and safety. Measures of efficacy in the reviewed articles included the alleviation of human immunodeficiency virus (HIV)-related signs and symptoms, improvements in quality of life, improvements in long-term survival, counteraction of the adverse side effects of antiviral drugs, promotion of immune reconstitution, and improvement of laboratory results. In sum, the literature indicates that TCM is safe. TCM plays an important role in the treatment of AIDS. Some studies have attempted to measure the efficacy and safety of TCM for treating AIDS, but more evidence is needed. Therefore, more research on this topic is required in the future.
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Affiliation(s)
- Zhi-Bin Liu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, 19 Ren Min Road, Zhengzhou, 450000, Henan, China. .,Discipline of Internal Chinese Medicine, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China. .,Department of Cellular Immunology Laboratory, Key Laboratory of Viral Diseases Prevention and Treatment of Traditional Chinese Medicine of Henan Province, Zhengzhou, 450000, Henan, China.
| | - Ji-Ping Yang
- Discipline of Internal Chinese Medicine, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China.
| | - Li-Ran Xu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, 19 Ren Min Road, Zhengzhou, 450000, Henan, China.
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9
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Gromek K, Drumond N, Simas P. Pharmacovigilance of herbal medicines. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2015; 27:55-65. [DOI: 10.3233/jrs-150643] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Xu LR, Guo HJ, Liu ZB, Li Q, Yang JP, He Y. Unified-planning, graded-administration, and centralized-controlling: a management modality for treating acquired immune deficiency syndrome with Chinese medicine in Henan Province of China. Chin J Integr Med 2015; 21:243-8. [PMID: 25877652 PMCID: PMC7089398 DOI: 10.1007/s11655-015-2138-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Indexed: 10/31/2022]
Abstract
Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded-administration, and centralized-controlling (UGC). The UGC modality has one primary concept (patient-centered medicine from CM theory), four basic foundations (classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV), six important relationships (the "three uniformities and three combinations," and the six relationships therein guide the treatment of AIDS with CM), and four key sections (management, operation, records, and evaluation). In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.
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Affiliation(s)
- Li-Ran Xu
- Department of Acquired Immune Deficiency Syndrome Treatment and Research Center, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, 450000, China
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Survival of AIDS patients treated with traditional chinese medicine in rural central china: a retrospective cohort study, 2004-2012. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:282819. [PMID: 25821482 PMCID: PMC4363674 DOI: 10.1155/2015/282819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 11/29/2014] [Accepted: 11/30/2014] [Indexed: 11/18/2022]
Abstract
This study aimed to explore the survival of AIDS patients treated with traditional Chinese medicine (TCM) in addition to combined antiretroviral therapy (cART) and of AIDS patients treated with cART. Data of patients taking cART between 30 October 2003 and 30 October 2004 in the National TCM HIV Treatment Trial Program area were retrospectively analyzed, with follow-up from 30 October 2004 to 30 October 2012. The log-rank test was used to compare survival between the two groups. A Cox proportional hazards model was used to determine hazard ratios to identify prognostic factors. The study included 521 patients in the TCM + cART group followed up for 3548 person-years and 375 patients in the cART group followed up for 2523 person-years. Mortality rates were 3.2/100 person-years and 4.2/100 person-years in the TCM + cART and cART groups, respectively. The difference in survival was significant. After adjusting for explanatory variables, the mortality rate of AIDS patients in the cART group was 1.7 times higher than in the TCM + cART group. Male sex, older age, little education, and lower CD4 cell count were risk factors for mortality. TCM intervention in addition to cART could increase survival of AIDS patients.
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