An 84-month observational study of the changes in CD4 T-lymphocyte cell count of 110 HIV/AIDS patients treated with traditional Chinese medicine

Abstract

This study aimed to evaluate the therapeutic effect of traditional Chinese medicine (TCM) by observing the changes in CD4 T-lymphocyte cell count of 110 cases with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) treated continuously with TCM for 84 months. Information of 110 HIV/AIDS patients from 19 provinces and cities treated with TCM from 2004 to 2013 was collected. Changes in the indexes of CD4 counts (≤200, 201–350, 351–500 and>500 cells/mm³) at five time points (0, 12, 36, 60 and 84 months) and different treatments [TCM and TCM plus antiretroviral therapy (ART)] were compared. Repeated measures test indicated no interaction between group and time (P>0.05). Degrees of increasing and decreasing CD4 count of the two groups at four different frames were statistically significant compared with the baseline. The CD4 count between the two groups was not statistically significant. For CD4 count of≤200 cells/mm³, the mean CD4 count changes were 21 and 28 cells/mm³ per year for the TCM group and TCM plus ART group, respectively. For CD4 count of 201–350 cells/mm³, the mean CD4 count changes were 6 and 25 cells/mm³ per year for the TCM group and TCM plus ART group, respectively. For CD4 count of 351–500 cells/mm³, the mean CD4 count changes were −13 and −7 cells/mm³ per year for the TCM group and TCM plus ART group, respectively. For CD4 count of>500 cells/mm³, the mean CD4 count changes were −34 and −17 cells/mm³ per year for the TCM group and TCM plus ART group, respectively. Long-term use of TCM could maintain or slow the pace of declining CD4 counts in patients with HIV/AIDS, and may achieve lasting effectiveness.

Keywords

AIDS / HIV / CD4 / traditional Chinese medicine / linear models

References

[1] National Center for AIDS/STD Control and Prevention, China CDC. Work background of AIDS control and prevention in China. 2014.

[2] Hogg RS, Heath KV, Yip B, Craib KJ, O’Shaughnessy MV, Schechter MT, Montaner JS. Improved survival among HIV-infected individuals following initiation of antiretroviral therapy. JAMA 1998; 279(6): 450−454

[3] Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P, d’Arminio Monforte A, Yust I, Bruun JN, Phillips AN, Lundgren JD. Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study Group. Lancet 1998; 352(9142): 1725−1730

[4] Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 1998; 338(13): 853−860

[5] Chou R, Huffman LH, Fu R, Smits AK, Korthuis PT; US Preventive Services Task Force. Screening for HIV: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2005; 143(1): 55−73

[6] Hawkins T. Appearance-related side effects of HIV-1 treatment. AIDS Patient Care STDS 2006; 20(1): 6−18

[7] d’Arminio Monforte A, Lepri AC, Rezza G, Pezzotti P, Antinori A, Phillips AN, Angarano G, Colangeli V, De Luca A, Ippolito G, Caggese L, Soscia F, Filice G, Gritti F, Narciso P, Tirelli U, Moroni M. Insights into the reasons for discontinuation of the first highly active antiretroviral therapy (HAART) regimen in a cohort of antiretroviral naïve patients. I.CO.N.A. Study Group. Italian Cohort of Antiretroviral-Naïve Patients. AIDS 2000; 14(5): 499−507

[8] Park IW, Han C, Song X, Green LA, Wang T, Liu Y, Cen C, Song X, Yang B, Chen G, He JJ. Inhibition of HIV-1 entry by extracts derived from traditional Chinese medicinal herbal plants. BMC Complement Altern Med 2009; 9(1): 29

[9] Vickers A. Recent advances: complementary medicine. BMJ 2000; 321(7262): 683−686

[10] Liu J. The use of herbal medicines in early drug development for the treatment of HIV infections and AIDS. Expert Opin Investig Drugs 2007; 16(9): 1355−1364

[11] Wang J, Zou W, Liu Y. Use of traditional Chinese medicine in HIV/AIDS in China. J Biomed Sci Eng 2010; 3(8): 828−831

[12] Chu CX, Xu YS, Li J, Zhao SP, Li YF. Analysis on first detection of CD4⁺ T lymphocytes for new HIV-infected persons in Kunming in 2011. Pract Prev Med (Shi Yong Yu Fang Yi Xue) 2013; 20(6): 705−707 (in Chinese)

[13] Xu LR, Li FZ, He Y, Guo JZ, Wang D. Sixty- month clinical observation of HIV carriers/ AIDS patients treated with Yiaikang capsule in terms of theirs CD4⁺ T counts and viral loads. Chin J AIDS STD (Zhongguo Ai Zi Bing Xing Bing) 2010; 16(3): 231−233 (in Chinese)

[14] Wang J, Liu Y, Zou W, Xu LR, Fang L, Wang YG, Zhang GL, Lu JM, Zhou J. Clinical observation of effect of traditional Chinese herbs on CD4 count in 807 people living with HIV/AIDS. Chin J AIDS STD (Zhongguo Ai Zi Bing Xing Bing) 2010; 16(3): 208−210 (in Chinese)

[15] Wang J, Liang BY, Lu JM, Zhang XP, Xu LR, Deng X, Li XH, Fang L, Tan XH, Mao YX, Zhang GL. A sixty-months study of the change of CD4 T-lymphocyte cell count treated with traditional Chinese medicine in 565 HIV/AIDS patients. Chin J AIDS STD (Zhongguo Ai Zi Bing Xing Bing) 2013; 19(7): 468−471 (in Chinese)

[16] Ma YC, Qin GM, Zheng GY, Liu L, Zhang LL, Liu G, Mao XY. Study on combined test with two kinds of different format HIV-Ab ELISAs as a substitute for western blot. Chin J STD/AIDS Prev Cont (Zhongguo Xing Bing Ai Zi Bing Fang Zhi) 2002; 8(6): 335−336 (in Chinese)

[17] AIDS group of Society of Infectious Diseases, CMA. Guidelines for treating AIDS. Chin J Infect Dis (Zhonghua Chuan Ran Bing Za Zhi) 2006; 24(2): 137 (in Chinese)

[18] Experts Group of Treating HIV/AIDS with TCM of National Health and Family Planning Commission of the People’s Republic of China. Clinical Technology Solutions of National Free Treating HIV/AIDS with TCM Program (Trial). Health Office Medical Care Administration File [2005] No. 19 (in Chinese)

[19] Finney DJ. Repeated measurements: what is measured and what repeats? Stat Med 1990; 9(6): 639−644

[20] Yu SL, Xiang HY. Analysis of Variance and SAS Program of Repeated Data. Beijing: Science Press, 2004: 12−40 (in Chinese)

[21] Liu L, Gao Y. Study on the correlation between traditional Chinese medicine syndrome and short-term prognosis of ischemic stroke using logistic regression model and repeated-measures analysis of variance. J Chin Integr Med (Zhong Xi Yi Jie He Xue Bao) 2012; 10(9): 983−990 (in Chinese)

[22] Qiu H, Jin GQ, Jin RF, Zhao WK. Analysis of variance of repeated data measured by water maze with SPSS. J Chin Integr Med (Zhong Xi Yi Jie He Xue Bao) 2007; 5(1): 101−105 (in Chinese)

[23] Zhao HX, Zhang FJ. Opportunities and challenges of treating HIV/AIDS with TCM plus western medicine. Chin J AIDS STD (Zhongguo Ai Zi Bing Xing Bing) 2008; 14(4): 425−427 (in Chinese)

[24] Badri M, Ehrlich R, Wood R, Maartens G. Initiating co-trimoxazole prophylaxis in HIV-infected patients in Africa: an evaluation of the provisional WHO/UNAIDS recommendations. AIDS 2001; 15(9): 1143−1148

[25] Cen YW, Fu LC, Tan XH, Zhang MM, Ma BY. Investigation of TCM syndrome in HIV/AIDS patients of Guangdong. Chin Arch Tradit Chin Med (Zhonghua Zhong Yi Yao Xue Kan) 2008; 26(5): 958−961 (in Chinese)

[26] Wang J, Liang BY, Yan SY, Lu JM, Xu LR, Wang YG, Fang L, Zhang GL, Li XH, Mao YX, Deng X, Li XD, Wang JW. Clinical observation on 8946 AIDS cases treated by traditional Chinese medicine. J Tradit Chin Med (Zhong Yi Za Zhi) 2011; 52(5): 395−398 (in Chinese)

Acknowledgements

The authors thank the staff and patients of 19 pilot projects of Chinese medicine treatment of AIDS.

Compliance with ethics guidelines

Jian Wang, Biyan Liang, Xiaoping Zhang, Liran Xu, Xin Deng, Xiuhui Li, Lu Fang, Xinghua Tan, Yuxiang Mao, Guoliang Zhang and Yuguang Wang declare that they have no conflict of interest. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for inclusion in the study.

RIGHTS & PERMISSIONS

2014 Higher Education Press and Springer-Verlag Berlin Heidelberg