J. Biomedical Science and Engineering, 2010, 3, 833-836
doi:10.4236/jbise.2010.39112 Published Online September 2010 (http://www.SciRP.org/journal/jbise/ JBiSE ).
Published Online September 2010 in SciRes. http:// www.scirp.org/journal/jbise
Assessing the effect of traditional Chinese medicine on CD4+
lymphocyte count of 807 HIV/AIDS cases*
Jian Wang1, Wen Zou1, Ying Liu1, Liran Xu 2, Fang Lu 3, Yuguang Wang 4, G uol ia ng Zhang 5,
Jiaming Lu 1, Jun Zhou 1
1Traditional Chinese Medicine Center for AIDS Prevention and Treatment, China Academy of Chinese Medicine Sciences, Beijing,
China;
2Henan Academy of Traditional Chinese Medicine, Zhengzhou, China;
3Yunnan Academy of Traditional Chinese Medicine, Kunming, China;
4Beijing Ditan Hospital, Beijing, China;
5An’hui Hospital of Traditional Chinese Medicine, Hefei, China.
Received 20 May 2010; revised 8 June 2010; accepted 21 June 2010.
ABSTRACT
National Free Traditional Chinese Medicine (TCM)
HIV/AIDS Treatment Program had been carried out
for more than 5 years, treating 9267 cases accumulate-
ly by 2009. We report the 3-year outcome on CD4+
lymphocyte count of 807 cases of HIV/AIDS enrolled
in the National Free TCM HIV/AIDS Treatment Pro-
gram, the CD4+ lymphocyte count were measured
every 6 month at 7 time points (0, 6, 12, 18, 24, 30, 36
month). The results showed that the overall CD4+ ly
mphocyte count maintained stable at the 6th month
and the 12th month, declined significantly at the 18th
month, 24th month and 30th month, then elevated to
the pre-treatment level at the 36th month. Patients
with pre-treatment CD4+ lymphocyte count level <
200/mm3, who possibly combined HAART therapy,
had CD4+ lymphocyte count elevated significantly af-
ter all visits. Patients with pre-treatment CD4+ lymp-
hocyte count level between 200 and 350/mm3 mainta-
ined stable before the 36th month, and then rosed sig-
nificantly, which implicated the long-term effect of
TCM. Patients with pre-treatment CD4+ lymphocyte
count level > 350/mm3 had CD4+ lymphocyte count
declined significantly after all visits. In summary, co-
mbined treatment of Chinese herbal medicine and
conventional therapy on HIV/AIDS suggested prom-
ising effect, but more evidences from larger, rigorous
designed studies still needed to support the affirma-
tive effect of TCM in the future.
Keywords: Traditional Chinese Medicine; HIV/AIDS;
CD4+ lymphocyte count
1. INTRODUCTION
In China, an estimated 740,000 persons are infected with
HIV, of whom approximately 105,000 have developed
AIDS [1]. Of these, a cumulative of 319,877 patients,
had been id entified as o f Octob er 2009 [2 ]. Before 2 002,
when China initiated its National Free Antiretroviral Tr-
eatment Program as a pilot project among former plasma
donors [3,4], antiretroviral therapy (ART) was not readi-
ly available. Treatment was rapidly scaled up, and by Au-
gust 2008, more than 52,000 persons had received first-
line highly active antiretroviral therapy (HAART). Tra-
ditional Chinese Medicine (TCM) intervention started
from 2004, a pilot project named National Free TCM
HIV/AIDS Treatment Program had been launched by
The State Administrative bureau of Traditional Chinese
Medicine, and quickly scaled up from 5 provinces (He-
nan, Hebei, Anhui, Hubei, Guangdong) to 19 provinces,
autonomous regions, and municipalities in China inclu-
ding some places with high prevalence, 9267 cases have
been treated with TCM accumulatively by 2009.
HIV weakens the immune system by attacking CD4
lymphocyte count, CD4 lymphocyte count is a strong
predictor of assessing prognosis of AIDS. [5,6].
We report the 3-year outcome on CD4+ lymphocyte
count of 807 cases of HIV/AIDS enrolled in the Nati-
onal Free TCM HIV/AIDS Treatment Program by ret-
rospective analysis, the CD4+ lymphocyte count were
measured every 6 month at 7 time points (0, 6, 12, 18, 24,
30, 36 month).
*Granted Fund: State Major Science & Technology Specific Pro-
j
ects (2008ZX10005 -001).

J. Wang et al. / J. Biomedical Science and Engineering 3 (2010) 833-836 834
2. METHOD
2.1. Study Design and Setting
In China, all HIV-positive patients who meet the natio n-
al treatment guidelines of CD4+ lymphocyte count less
than 0.200 × 109 cells/L, total lymphocyte count less than
1.2 × 109 cells/L, or World Health Organization (WHO)
stage 3 or 4 disease are eligible to receive HAART[7].
When National Free TCM HIV/AIDS Treatment Pro-
gram launched by 2004, HIV-positive patien ts who were
willing to receive TCM can be enrolled in TCM program,
no matter its CD4+ lymphocyte count levels. After trea-
tment initiation, visits are sch eduled at 6 mon th, 12 mon-
ths, 18 months, and then every 6 months thereafter. Local
TCM health care providers from the program complete
visit-specific forms at each visit, all the information was
imputed into the database. We selected 807 cases from
the database which had good TCM compliance. 80% of
them were paid bloo d donors from Henan Provin ce with
average age at 41. Male 377, female 430, 222 cases of
them had comb ined with HAART therapy. Chinese herb
medicine adopted prescriptions according to syndrome
differentiation or patent used by local doctors from each
province.
2.2. Statistical Analysis
T-Test statistic was used in this study for quantitative
variables. SPSS, version 13.0 (SPSS, Chicago, Illinois),
and SAS, version 9.13 (SAS Institute, Cary, North Car-
olina), was used for all analyses. All hypothesis testing
was 2-sid ed, wit h anαlevel of 0. 0 5 .
3. RESULTS
3.1. CD4+ Lymphocyte Count Overall Variation
The CD4+ lymphocyte count maintained stable at the 6th
month and 12th month, declined significantly at the 18th
month, 24th month and 30th month, then elevated to the
pre-treatment level at 36th month (Table 1).
3.2. CD4+ Lymphocyte Count Variations by
Different Pre-Treatment Level
Patients with pre-treatment CD4+ lymphocyte count le-
vel < 200/mm3, who possibly combined HAART therapy,
had CD4+ lymphocyte count elevated significantly after
all visits (Table 2). Patients with pre-treatment CD4+ ly-
mphocyte count level between 200 and 350/mm3 main-
tained stable before 36 months, and then rose signifi-
cantly (Table 3), which implicated the long-term effect
of TCM. Patients with pre-treatment CD4+ lymphocyte
count level > 350 /mm3, had CD4+ lymphocyte count de-
clined significantly after all visits (Table 4).
3.3. CD4+ Lymphocyte Count Variations by
Different Clinical Stages
CD4+ lymphocyte count of patients at both stage ma-
intained stable at all visits which may implicated TCM
effect (see Table 5,6).
Table 1. CD4+ lymphocyte count overall variation pre-post TCM treatment (/mm3).
months case pre
(sx ) post (sx ) t-test P
0 807 340.42 ± 202.14
6 129 296.10 ±159.47 –0.303 <0.763
12 365 324.81 ± 311.76 –1.688 <0.092
18 426 287.34 ± 168.49 3.141 <0.002
24 476 280.57 ± 170.09 4.109 <0.000
30 384 298.40 ± 175.26 2.478 <0.014
36 807 346.02 ± 231.11 –0.885 <0.377
Table 2. CD4+ lymphocyte count variation with pre-treatment level < 200 (/mm3).
months case pre
(sx ) post (sx ) t-test P
0 210 120.56 ± 55.63
6 37 207.00 ± 160.12 –3.597 <0.001
12 110 234.42 ± 151.61 –8.527 <0.000
18 116 199.53 ± 143.60 –5.832 <0.000
24 114 222.88 ± 171.35 –6.055 <0.000
30 84 196.41 ± 121.02 –5.521 <0.000
36 210 249.69 ± 188.67 –9.656 <0.000

J. Wang et al. / J. Biomedical Science and Engineering 3 (2010) 833-836 835
Table 3. CD4+ lymphocyte count variation with pre-treatment level between 200-350 (/mm3).
months case pre
(sx ) post (sx ) t-test P
0 258 276.53 ± 43.14
6 38 282.15 ± 104.19 –0.076 <0.940
12 105 318.19 ± 470.41 –1.018 <0.311
18 130 274.20 ± 128.30 0.163 <0.871
24 151 269.90 ± 147.63 0.768 <0.444
30 119 285.06 ± 144.18 –0.175 <0.862
36 258 307.13 ± 182.81 –2.635 <0.009
Table 4. CD4+ lymphocyte count variation with pre-treatment level between > 350 (/mm3).
months case pre
(sx ) post (sx ) t-test P
0 339 525.24 ± 163.42
6 34 389.67 ± 171.40 3.553 <0.0 01
12 118 434.23 ± 235.69 3.331 <0.001
18 139 377.65 ± 183.26 9.093 <0. 000
24 152 338.47 ± 181.27 10.227 <0.000
30 127 392.29 ± 195.24 6.909 <0. 000
36 339 440.10 ± 257.09 6.074 <0. 000
Table 5. CD4+ lymphocyte count variation of patients at asymptomatic stage (/mm3).
months case pre
(sx ) post (sx ) t-test P
0 513 367.54 ± 216.48
6 62 289.62 ± 179.22 –0.671 <0.505
12 213 359.63 ± 381.49 –0.961 <0.338
18 232 302.64 ± 174.12 3.383 <0. 001
24 257 288.39 ± 176.62 4.033 <0. 000
30 202 322.99 ± 188.09 2.042 <0. 043
36 499 363.96 ± 250.55 0.383 <0. 702
Table 6. CD4+ lymphocyte count variation of patients at AIDS stage (/mm3).
months case pre
(sx ) post (sx ) t-test P
0 294 285.99 ± 162.30
6 47 286.74 ± 136.31 0.066 <0.9 48
12 116 279.72 ± 159.36 –2.793 <0.006
18 149 264.55 ± 161.55 0.254 <0. 800
24 156 268.32 ± 161.83 1.282 <0. 202
30 125 269.24 ± 155.85 1.078 <0. 283
36 308 319.32 ± 198.79 –2.828 <0.005
4. DISCUSSION
It has been 23 years since Chinese government sent TCM
doctors to aid Tanzania HIV/AIDS patients, therapeutic
effect has been achieved through ten thousands of accu-
mulative Tanzania HIV/AIDS cases. It was reported that
23 cases of Tanzania patients with more than 10 years
HIV/AIDS history maintained their CD4+ lymphocyte
count stable around 350/mm3 by use of TCM[8]. Exper-
imental study also showed that Chinese herb compound
prescription ZY-1 may help activation and hyperplasia
of CD4 cell in lymph nodes [9].
In our study, the overall CD4+ lymphocyte count ma-
intained stable at the 6th month and 12th month, decl-

J. Wang et al. / J. Biomedical Science and Engineering 3 (2010) 833-836 836
ined significantly at 18th month, 24th month and 30th
month, then elevated to the pre-treatment level at 36th
month, which was in accordance with the result of clini-
cal trial conducted by Wang Jian et al. In that trial, CD4
count decreased in both groups (Aining granule + HA-
ART; placebo + HAART) after 11 months treatment, the
decrease of mean value of CD4 was significantly less in
the Aining group (–87.65 ± 107.98/mm3) than in the
control gr oup (–156.51 ± 157.04/mm3, P < 0.05) [10].
By analysis of database, Patients with pre-treatment
CD4+ lymphocyte count level < 200/mm3, who possibly
combined HAART therapy, had CD4+ lymphocyte co-
unt elevated significantly after all visits. Patients with
pre-treatment CD4+ lymphocyte count level between
200 and 350/mm3 maintained stable before 36 months,
and then rose significantly, which implicated the long-
term effect of TCM. Patients with pre-treatment CD4+
lymphocyte count level > 350/mm3 had CD4+ lympho-
cyte count declined significantly after all visits.
In summary, combined treatment of Chinese herbal
medicine of HIV/AIDS suggested promising effect, but
more evidence from larger, rigorous designed studies
still needed to support the affirmative effect of TCM in
the future.
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