Health Management of AIDS Patients Using Chinese Medicine: A Theoretically Reliable, Practically Feasible, and Conveniently Operative Plan

China is a low-prevalence country with almost 85 thousand people living with Human Immunodeficiency Virus (HIV) in China by the end of 2018yr [1]. As a chronic and incurable today, the lifelong medication of cART is often limited by drug side-effects, adherence to therapy, social discrimination, and even high drug resistance [2]. Medical care is one of the guarantees for AIDS survival. For a developing country with limited medical resources, the majority of AIDS patients are living in poor areas of China, patients had few opportunities and capabilities to get enough western medical care but other than free antiviral therapy. Thus, medical care is not limited to Western medicine (WM). For Chinese medicine (CM) has a long history of thousands of years，which has been mediated by the Chinese government as Western medicine (WM) as one of mainstream medicine, even though CM is considered a complementary or alternative medical system in most Western countries.

In daily practice, many CM practitioners(CMPs) often provide CM treatment for patients such as qigong, Chinese herbs, acupuncture and moxibustion, etc., meanwhile many people often volunteer to ask for help from CM alone or integral with WM for AIDS and HIV related signs managing, and this conventional practice has flourished in china. CD4+ T cell counts, and HIV loads had been recommended as a golden evaluation criterion by World Health Organization (WHO) or WM for AIDS therapy. But to CM, more concerns are the clinical complains of AIDS patients including abnormal symptoms and signs, lower level of quality of life (QOL), complication, opportunistic infections and side-effects of cART rather than CD4+ T cell counts and levels of HIV loads. The usage of CM is based on clinical practice with the humanity characteristics, holistic approach and differentiation of syndrome and prescription. As it has been believed, CM has the holistic adjustment effects which lead many CMPs and patients to believe that CM can treat any complex multi-system diseases. Since 2004yr, the State Administration of Traditional Chinese Medicine of P.R. China had executed a pilot program for the use of CM to treat AIDS patients in conjunction with anti-retrovirus drugs and lots of technology and science projects for AIDS，some national projects had been founded by the government of China [3], and meanwhile some management modalities for treating AIDS with CM had gradually formed [4]. From that time on, the role of CM in the treatment of AIDS had been confirmed gradually. It had been reported that CM has the multi-effects [5], such as ameliorating symptoms and signs [6], increasing CD4+ T cell counts, reducing plasma HIV viral loads, reducing opportunistic infections, improving QOL, counter acting against the effects of anti-retroviral drugs, promoting immune function reconstruction [7], and even increasing survival of AIDS patients [8]. with some advantages including the rich resource of Chinese herbs, the cheaper cost and fewer side effects.

As a relatively safe treatment method，only few studies had found some slight side effects in some open reported articles. But the safety of CM still requires vigilance [9], for example some researchers had found some herbs medicine could interfere with the antiviral drug metabolism and change the concentration of the antiviral drugs [10]. To date, the facilitator of the AIDS treating with CM is not only the needs of the patients, but also Shortages and side effects of antiviral drugs. CM has played important role on AIDS treating with the unique humanistic care and the holistic adjustment. In some areas, the participants can get CM free, and in other areas, any patient is very easy to get CM treatment through consulting from CMPs and other approaches as followings: Firstly: the national project is the main mode for participate to get TCM treating.

For the State Administration of TCM of P.R. China carried out a trial program, and different fixed preparation and additional TCM treatment were supplied for the participants in five different provinces of China. Secondly: Free clinic model is very convenient. PLWH usually did not inform about his or her HIV status to CMPs at an ordinary clinic when he or she come to see a doctor, and the CMP usually makes diagnose and treatment according to the patient’s four diagnostic information with CM approach. Thirdly: self-management model of CM is popular. When a person wants to get CM treatment or health care, he or she can get it easily. i.e., to purchase herb medicine (OTC), preparation of herb medicine for tea drinks and medicinal meals, Non-drug therapy (Qigong, massage, acupuncture. those were popular mode of health management. The usage of CM become more common among people living with HIV, more AIDS patients are benefiting from CM, some researches had shown some encouraged results, and some evidences based highquality clinical studies to confirm the effectiveness and safety of CM strategy for managing HIV alone or combination with WM plan probably will be published in the future.

Yanan Liu, Jingyu Zang, Jinyan Pei, Jun Yang and Yuqing Ma conceived this paper; Yanan Liu, Jingyu Zang, Zhibin Liu and Yantao Jin drafted the manuscript, Qianlei Xu, Huijun Guo and Qiang Li participated in redrafting and rewriting. All authors have read and approved the final manuscript.

Supported by the National Natural Science Foundation of China (81803953, 81873289 and 81873187), National Special Science and Technology Program on Major Infectious Diseases (2017ZX10205502002 and 2017ZX10205502003).

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