The effect of Chinese medicine therapeutics on HIV/AIDS: A systematic review and network meta-analysis

Abstract

Background

Although antiretroviral therapy (ART) effectively suppresses HIV, incomplete immune reconstitution affects 20%–30% of adherent patients. Chinese Medicine (CM) demonstrates potential as a complementary therapy for human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), yet its long-term impact on immune recovery remains unestablished. This network meta-analysis (NMA) aimed to compare CM interventions for enhancing CD4+ T-cell counts and overall efficacy in HIV/AIDS management.

Methods

We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to 27 August 2024 for randomized controlled trials (RCTs) and observational studies on CM for HIV/AIDS. Bayesian NMA was conducted using R 4.2.2 with BUGSnet 1.1.0 package. Surface under cumulative ranking (SUCRA) probabilities ranked interventions. Risk of bias was assessed with Cochrane ROB 2.0 for RCTs and Newcastle-Ottawa Scale for observational studies (PROSPERO: CRD42024560340).

Results

A total of 34 studies (n = 8,933 participants) evaluating 16 interventions were included. Key findings: For CD4+ restoration, Chinese herbal formulae plus ART significantly outperformed ART alone (MD = 163 cells/μL, 95% Bayesian credible interval [CrI]: 3.93–326.46), ranking first (SUCRA = 0.92). Single herbs plus ART ranked second for CD4+ recovery (MD = 178.54, 95% CrI: −188.57–553.24; SUCRA = 0.85). In overall treatment efficacy (survival/quality of life), Chinese herbal formulae plus Western medical therapy demonstrated the highest SUCRA (0.96).

Conclusion

CM-ART combinations—particularly Chinese herbal formulae with ART—optimize immune reconstitution in HIV/AIDS. Chinese herbal formulae plus ART represents the most effective CD4+ restoration strategy. These findings support integrating evidence-based CM into HIV care, but pharmacokinetic interactions and long-term safety require validation through multicenter trials.

Authors

Hongxi W, Qinglian H, Yiyang L, Jiale L, Zhenjin H, Huiping L, Rongxin Z, Ruting W, Yuanbo S, Feng J

Year

2025

Topics

  • Population(s)
    • General HIV+ population
  • Prevention, Engagement and Care Cascade
    • Engagement and Care Cascade
  • Engagement and Care Cascade
    • Treatment
  • Health Systems
    • Delivery arrangements

Link

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