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

## TL;DR

This study reviews Chinese medicine's role in improving immune recovery in HIV/AIDS patients when combined with standard treatments.

## Contribution

The study provides the first network meta-analysis comparing various Chinese medicine interventions for HIV/AIDS immune recovery.

## Key findings

- Chinese herbal formulae plus ART significantly improved CD4+ T-cell counts compared to ART alone.
- Chinese herbal formulae plus ART ranked highest for overall treatment efficacy in HIV/AIDS management.
- Pharmacokinetic interactions and long-term safety of CM-ART combinations require further validation.

## Abstract

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.

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).

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).

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.

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024560340, PROSPERO CRD42024560340.

Network and forest plots evaluated the efficacy of TCM in treating HIV/AIDS. The network diagram illustrated direct comparisons between different therapeutic regimens. The two forest plots respectively compared Western medicine versus other therapies in terms of overall response rate, and ART versus other treatments regarding changes in CD4+ cell count.Network plot and forest plot analyze the efficacy of Chinese medicine treatments for HIV/AIDS. The network plot shows relationships among different therapies, while the forest plot compares risk ratios and CD4+ cell count changes relative to ART and western medical treatments.

Network and forest plots evaluated the efficacy of TCM in treating HIV/AIDS. The network diagram illustrated direct comparisons between different therapeutic regimens. The two forest plots respectively compared Western medicine versus other therapies in terms of overall response rate, and ART versus other treatments regarding changes in CD4+ cell count.