Popular Use of Traditional Chinese Medicine in HIV Patients in the HAART era

Kurtland Ma; Shui-Shan Lee; Elsie K. Y. Chu; Dennise K. P. Tam; Victoria S. C. Kwong; Choi-Fung Ho; Kathy Cheng; Ka-Hing Wong

Disclosures

AIDS and Behavior. 2008;12(4):637-642. 

In This Article

Abstract and Introduction

Abstract

Seventy-six Chinese male HIV patients were interviewed on their use of traditional Chinese medicine (TCM). All except one had undetectable viral load, 28 had already progressed to AIDS. Forty-five (59.2%) had used TCM - 11 infrequently and 33 commonly. No specific TCM recipe was preferentially used, while a variety of herbal tea and other over-the-counter health products of TCM in origin were reported. A minority (28.9%) have consulted a TCM practitioner in the preceding 6 months. Most patients admitted using TCM for the treatment of minor ailments (60.0%) and general health maintenance (57.8%), while western medicine was chosen for the therapy of major medical illnesses. TCM did not seem to have significant influence on the conventional HAART in this cohort. Many used TCM at a time interval from HAART in order not to affect the latter's effectiveness.

Introduction

Complementary and alternative therapy (CAM) refers to the use of treatment not provided by clinicians in conventional health services, though both serve the same goal of pursuing good health (Ni, Simile, & Hardy, 2002). Traditional Chinese Medicine (TCM) constitutes one form of CAM which is widely used in Chinese communities around the world. In Hong Kong where over 95% of the population is ethnic Chinese, many believe Western medication and TCM care are complementary (Lee, 1983). From 10 to 15% of people reported the use of TCM or consulted herbalist for specific health problem (Lau, Leung, & Tsui, 2001; Wong, Wong, & Donnan, 1995). The proportion of those who had used TCM at least once was much higher (Hon et al., 2004; Tang & Wong, 1998; Wong et al., 1995). The integration of Western medication and TCM may carry significant implications in healthcare outcomes, especially in places where the use of TCM is widespread. This applies to conditions like HIV/AIDS which is becoming a chronic disease the best care model of which is yet to be established.

In the West, the prevalence of CAM use ranged between 27 and 100% of HIV patients from 1980 to 1996 (Ernst, 1997). In some studies up to 70% of HIV/AIDS patients have used CAM in the course of their illness (Fairfield, Eisenberg, Davis, Libman, & Phillips, 1998; Furler, Einarson, Walmsley, Millson, & Bendayan, 2003), the variation of which depends on the definition and study designs. Data from Asia is only available in a Thailand study in 2003, with 95% of the HIV patients reporting the use of some forms of CAM, and 78% having visited a CAM provider (Wiwanitkit, 2003). A significant proportion of these studies were conducted before the introduction of highly active antiretroviral therapy (HAART), the latter becoming a gold standard in clinical HIV management. With the widespread use of HAART in not just developed but developing countries, there is the new concern about interaction between CAM and HAART, which may potentially affect the outcome of treatment (Mills, Montori, Perri, Phillips, & Koren, 2005).

We set out to explore the pattern of TCM use by ethnic Chinese HIV patients. Hong Kong is uniquely positioned for such a study in light of the high proportion of Chinese patients, access to TCM and TCM practitioners, superimposed on the pre-existing western health care system. HAART has become a standard of HIV treatment in the territory since the mid-nineties, enabling the impacts of TCM use to be studied.

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