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
N1 - Funding Information:
This study was supported by grants from China Medical University ( CMU102-PH-01 and CMU100-S-01 ), China Medical University Hospital ( DMR-105-031 , DMR-105-098 , and DMR-106-155 ), the National Science Council, the Ministry of Science and Technology, Taiwan ( MOST 103-2320-B-039-006-MY3 , MOST 105-2314-B-039-037-MY3 , and MOST 106-2320-B-039-017-MY3 ), and China Medical University under the Aim for Top University Plan of the Ministry of Education, Taiwan . This study was based in part on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health and managed by the National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the National Health Insurance Administration, Department of Health or National Health Research Institutes. The authors wish to thank the Division of Chinese Medicine, China Medical University, Beigang Hospital, for administrative assistance and consultation, and the Aim for Top University Plan of the Ministry of Education, Taiwan, at China Medical University. We also thank Dr. Kuan-Teh Jeang and Willy W.L. Hong for their technical help and suggestions.
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/6/12
Y1 - 2018/6/12
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.
AB - 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.
KW - Cardiovascular disease
KW - Chinese herbal medicine
KW - HIV
KW - Hyperlipidemia
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U2 - 10.1016/j.jep.2018.03.006
DO - 10.1016/j.jep.2018.03.006
M3 - Article
AN - SCOPUS:85044169910
VL - 219
SP - 71
EP - 80
JO - Journal of Ethnopharmacology
JF - Journal of Ethnopharmacology
SN - 0378-8741
ER -