title: Traditional Chinese medicine could increase the survival of people living with HIV in rural central China: a retrospective cohort study, 2004-2012.
abstract: A retrospective cohort study was conducted to explore the effectiveness of Traditional Chinese Medicine (TCM) in treating people living with HIV (PLHIV) by comparing the survival of PLHIV treated with TCM and without TCM. To identify prognostic factors that affect the survival of PLHIV, patients who enrolled in the national TCM HIV treatment trial program (NTCMTP) in October 2004 and PLHIV in the same region who did not enroll in the NTCMTP were compared. Participants were followed up to October 2012. Survival time was estimated through the Kaplan-Meier method, and hazard ratios to identify prognostic factors were computed through Cox proportional hazard models. A total of 3,229 PLHIV (1,442 in the TCM therapy group and 1,787 in the non-TCM therapy group) were followed up for 21,876 person-years. In this time period, 751 (23.3%) died and 209 (6.5%) were lost to follow-up, for an overall mortality rate of 3.43/100 person-years. In the TCM therapy group, 287 (19.0%) died and 139 (9.7%) were lost to follow-up, and in the non-TCM therapy group, 464 (26.0%) PLHIV died and 70 (3.9%) were lost to follow-up. The mortality rate in the TCM therapy group was 2.97/100 person-years, which was lower than the rate of 3.79/100 person-years in the non-TCM therapy group. The 8-year cumulative survival in the TCM therapy group was 78.5%, lower than the 74.0% survival in the non-TCM therapy group. After adjusting for other factors, risk factors of death included male gender, older age, less education, taking combined antiretroviral therapy (cART) at enrollment, not taking cART at follow-up, and lower CD4 + T cell counts. Our retrospective cohort study indicates that TCM increased the survival and lengthened the lifetime of PLHIV in Henan Province of China. However, the limitations of a retrospective cohort could have biased the study, so prospective studies should be carried out to confirm our primary results.
authors.affiliation: National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, P. R. China , Department of AIDS Treatment and Research Center, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 45000, P. R. China.
authors.forename: Yantao
authors.initials: Y
authors.lastname: Jin
authors.forename: Huijun
authors.initials: H
authors.lastname: Guo
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Xiumin
authors.initials: X
authors.lastname: Chen
authors.forename: Ziqiang
authors.initials: Z
authors.lastname: Jiang
authors.forename: Guanpeng
authors.initials: G
authors.lastname: Hu
authors.forename: Jianghong
authors.initials: J
authors.lastname: Hou
authors.forename: Shiqing
authors.initials: S
authors.lastname: Jiang
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Yang
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Liran
authors.initials: L
authors.lastname: Xu
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
mesh_terms: D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D008517:Phytotherapy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D012424:Rural Population; D012737:Sex Factors; D015996:Survival Rate; D013995:Time
chemical_list: D019380:Anti-HIV Agents
keywords: Acquired Immune Deficiency Syndrome; Human Immunodeficiency Virus; Retrospective Cohort Study; Survival; Traditional Chinese Medicine