Chinese herbal medicine for incomplete immune reconstruction in patients with AIDS undergoing antiretroviral treatment: A systematic review of randomized trials

ObjectiveTo evaluate the effectiveness and safety of Chinese herbal medicines (CHMs) for incomplete immune reconstruction in patients with HIV/AIDS.MethodsEight electronic databases were searched for randomized controlled trials (RCTs) on the use of CHM for patients with HIV/AIDS with incomplete immune reconstruction. Outcomes included CD4⁺ cell count, quality of life, and adverse events/effects. The Cochrane Risk of Bias was employed to evaluate the methodological quality of the included RCTs.ResultsWe identified 13 eligible RCTs, with an overall high risk of bias, on 10 different CHMs. There was a significant increase in CD4⁺ cell count after the use of Jianpi Yiqi medicinal paste for 3 months; tripterygium glycosides tablets (TGTs) for 3 months (mean difference MD] 52.63 cells/μL, 95% confidence interval CI, 46.98, 58.28]), 6, 9, and 12 months; Wenshen Jianpi granules for 6 months; Shenling Fuzheng capsules for 6 months (MD 49.53 cells/μL, 95% CI 8.45, 90.61]) and 12 months; Aikeqing granules for 9 months (MD 61.51 cells/μL, 95% CI 16.25, 106.77]) and 12 months; Guipi decoction for 12 months; Mianyi No.2 granules (JT) for 12 and 18 months; and Chinese medicine granules for 18 months. The increase in the mean difference of CD4⁺ cell count from 6 to 18 months was larger in Chinese medicine granules and Mianyi No.2 granules (JT). Guipi decoction and Jianpi Qushi decoction improved the Karnofsky score. Four RCTs reported the outcome of adverse events/effects, while four cases of minor adverse effects were reported in the TGTs group.ConclusionJianpi Yiqi medicinal paste, Wenshen Jianpi granules, Shenling Fuzheng capsules, Aikeqing granules, Guipi decoction, and TGTs may be effective in increasing CD4⁺ within 12 months, and Mianyi No.2 granules (JT) and Chinese medicine granules may show long-term effects. High-quality large RCTs on the effectiveness and safety of CHMs are still warranted.