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

Objective: To evaluate the effectiveness and safety of Chinese herbal medicines(CHMs) for incomplete immune reconstruction in patients with HIV/AIDS.Methods: Eight 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.Results: We 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/m L, 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/m L, 95% CI [8.45, 90.61]) and 12 months; Aikeqing granules for 9 months(MD 61.51 cells/m L, 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.Conclusion: Jianpi 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.