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Effects of Chinese herbal medicine on hyperlipidemia and the risk of cardiovascular disease in HIV-infected patients in Taiwan.
J Ethnopharmacol. 2018 Jun 12; 219:71-80.JE

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Due to the development of antiretroviral therapy (ART), HIV/AIDS is now regarded as a treatable chronic disease. Chinese herbal medicine (CHM) is a type of complementary and alternative medicine (CAM) that has been widely applied in the healthcare system in Taiwan.

AIM OF THE STUDY

The aim of this study was to investigate the frequency of use and patterns of prescription for the CHM-based treatment of HIV-infected patients and to assess the long-term effects of CHM on hyperlipidemia and cardiovascular disease events in these patients.

MATERIALS AND METHODS

We identified 21,846 HIV-infected patients (ICD-9-CM: 042-044, 079, and V08 codes). Of these, 1083 and 2166 patients who used CHM and were non-users, respectively, were matched for age, gender, and ART use before CHM. The chi-squared test, Cox proportional hazard model, Kaplan-Meier method, and the log-rank test were used for comparisons between these two groups.

RESULTS

CHM users had a lower risk of hyperlipidemia compared with non-users after adjusting for comorbidities by using a multivariate Cox proportional hazard model (P = 0.0011; HR: 0.66, 95% CI: 0.52-0.85). In addition, the CHM users had a lower risk of cardiovascular disease compared with non-users after adjusting for comorbidities (P = 0.0004; HR: 0.67, 95% CI: 0.53-0.83). The 10-year cumulative incidences of hyperlipidemia and cardiovascular disease were lower in the CHM group (P < 0.0001 for both, log rank test). Among the 12 most commonly used CHMs in these patients, Jia-Wei-Xiao-Yao-San (JWXYS) (46.1%), Ge-Gen-Tang (GGT) (40.6%), and Yin-Qiao-San (YQS) (38.0%) were the most common herbal formulas used. Huang-Qin (HQin) (44.6%), Yan-Hu-Suo (YHS) (40.5%), and Jie-Geng (JG) (39.5%) were the most commonly used single herbs. A CHM network analysis showed that JG was the core CHM in one cluster, and BM, MXSGT, and HQin were important CHMs in that cluster. In the other cluster, YHS was the core CHM, and SYGCT and JWXYS were important CHMs.

CONCLUSION

CHM as adjunctive therapy may reduce hyperlipidemia and the risk for cardiovascular disease in HIV-infected patients. The list of the comprehensive herbal medicines that the patients used might be useful in further scientific investigations or therapeutic interventions for preventing atherosclerosis among HIV-infected patients.

Authors+Show Affiliations

School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Asia University, Taichung, Taiwan.School of Chinese Medicine, China Medical University, Taichung, Taiwan.Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan.School of Chinese Medicine, China Medical University, Taichung, Taiwan.Department of Microbiology and Immunology, Chang Gung University, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.School of Chinese Medicine, China Medical University, Taichung, Taiwan; Division of Chinese Medicine, China Medical University Beigang Hospital, Yunlin, Taiwan; Division of Chinese Medicine, Tainan Municipal An-Nan Hospital-China Medical University, Tainan, Taiwan.National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.School of Chinese Medicine, China Medical University, Taichung, Taiwan; Rheumatism Research Center, China Medical University Hospital, Taichung, Taiwan.School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.Department of Cosmetic Science, Providence University, Taichung, Taiwan.Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan. Electronic address: wmliang@mail.cmu.edu.tw.School of Chinese Medicine, China Medical University, Taichung, Taiwan; Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. Electronic address: yjlin.kath@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29530610

Citation

Tsai, Fuu-Jen, et al. "Effects of Chinese Herbal Medicine On Hyperlipidemia and the Risk of Cardiovascular Disease in HIV-infected Patients in Taiwan." Journal of Ethnopharmacology, vol. 219, 2018, pp. 71-80.
Tsai FJ, Li TM, Cheng CF, et al. Effects of Chinese herbal medicine on hyperlipidemia and the risk of cardiovascular disease in HIV-infected patients in Taiwan. J Ethnopharmacol. 2018;219:71-80.
Tsai, F. J., Li, T. M., Cheng, C. F., Wu, Y. C., Lai, C. H., Ho, T. J., Liu, X., Tsang, H., Lin, T. H., Liao, C. C., Huang, S. M., Li, J. P., Lin, J. C., Lin, C. C., Liang, W. M., & Lin, Y. J. (2018). Effects of Chinese herbal medicine on hyperlipidemia and the risk of cardiovascular disease in HIV-infected patients in Taiwan. Journal of Ethnopharmacology, 219, 71-80. https://doi.org/10.1016/j.jep.2018.03.006
Tsai FJ, et al. Effects of Chinese Herbal Medicine On Hyperlipidemia and the Risk of Cardiovascular Disease in HIV-infected Patients in Taiwan. J Ethnopharmacol. 2018 Jun 12;219:71-80. PubMed PMID: 29530610.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Chinese herbal medicine on hyperlipidemia and the risk of cardiovascular disease in HIV-infected patients in Taiwan. AU - Tsai,Fuu-Jen, AU - Li,Te-Mao, AU - Cheng,Chi-Fung, AU - Wu,Yang-Chang, AU - Lai,Chih-Ho, AU - Ho,Tsung-Jung, AU - Liu,Xiang, AU - Tsang,Hsinyi, AU - Lin,Ting-Hsu, AU - Liao,Chiu-Chu, AU - Huang,Shao-Mei, AU - Li,Ju-Pi, AU - Lin,Jung-Chun, AU - Lin,Chih-Chien, AU - Liang,Wen-Miin, AU - Lin,Ying-Ju, Y1 - 2018/03/10/ PY - 2017/07/05/received PY - 2017/12/26/revised PY - 2018/03/06/accepted PY - 2018/3/14/pubmed PY - 2018/10/3/medline PY - 2018/3/14/entrez KW - Cardiovascular disease KW - Chinese herbal medicine KW - HIV KW - Hyperlipidemia SP - 71 EP - 80 JF - Journal of ethnopharmacology JO - J Ethnopharmacol VL - 219 N2 - ETHNOPHARMACOLOGICAL RELEVANCE: Due to the development of antiretroviral therapy (ART), HIV/AIDS is now regarded as a treatable chronic disease. Chinese herbal medicine (CHM) is a type of complementary and alternative medicine (CAM) that has been widely applied in the healthcare system in Taiwan. AIM OF THE STUDY: The aim of this study was to investigate the frequency of use and patterns of prescription for the CHM-based treatment of HIV-infected patients and to assess the long-term effects of CHM on hyperlipidemia and cardiovascular disease events in these patients. MATERIALS AND METHODS: We identified 21,846 HIV-infected patients (ICD-9-CM: 042-044, 079, and V08 codes). Of these, 1083 and 2166 patients who used CHM and were non-users, respectively, were matched for age, gender, and ART use before CHM. The chi-squared test, Cox proportional hazard model, Kaplan-Meier method, and the log-rank test were used for comparisons between these two groups. RESULTS: CHM users had a lower risk of hyperlipidemia compared with non-users after adjusting for comorbidities by using a multivariate Cox proportional hazard model (P = 0.0011; HR: 0.66, 95% CI: 0.52-0.85). In addition, the CHM users had a lower risk of cardiovascular disease compared with non-users after adjusting for comorbidities (P = 0.0004; HR: 0.67, 95% CI: 0.53-0.83). The 10-year cumulative incidences of hyperlipidemia and cardiovascular disease were lower in the CHM group (P < 0.0001 for both, log rank test). Among the 12 most commonly used CHMs in these patients, Jia-Wei-Xiao-Yao-San (JWXYS) (46.1%), Ge-Gen-Tang (GGT) (40.6%), and Yin-Qiao-San (YQS) (38.0%) were the most common herbal formulas used. Huang-Qin (HQin) (44.6%), Yan-Hu-Suo (YHS) (40.5%), and Jie-Geng (JG) (39.5%) were the most commonly used single herbs. A CHM network analysis showed that JG was the core CHM in one cluster, and BM, MXSGT, and HQin were important CHMs in that cluster. In the other cluster, YHS was the core CHM, and SYGCT and JWXYS were important CHMs. CONCLUSION: CHM as adjunctive therapy may reduce hyperlipidemia and the risk for cardiovascular disease in HIV-infected patients. The list of the comprehensive herbal medicines that the patients used might be useful in further scientific investigations or therapeutic interventions for preventing atherosclerosis among HIV-infected patients. SN - 1872-7573 UR - https://www.unboundmedicine.com/medline/citation/29530610/Effects_of_Chinese_herbal_medicine_on_hyperlipidemia_and_the_risk_of_cardiovascular_disease_in_HIV_infected_patients_in_Taiwan_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0378-8741(17)32536-9 DB - PRIME DP - Unbound Medicine ER -