Clinical effects of adjunctive spleen- and kidney-invigorating Chinese herbal therapy combined with highly active antiretroviral treatment on immune recovery and nutritional status in people living with HIV.

OBJECTIVE: To evaluate whether adding a spleen- and kidney-invigorating Chinese herbal decoction to highly active antiretroviral therapy (HAART) improves immune recovery and nutritional status in people living with HIV. METHODS: Forty adults living with HIV were randomly allocated to receive either standard HAART alone or HAART plus a Chinese herbal decoction composed of astragalus, Chinese yam, dangshen, poria cocos, white atractylodes rhizome, radix pseudostellariae, and rehmannia glutinosa. Immune indices (CD4+, CD8+ T cells, Th17 cells), inflammatory cytokines (interferon-γ [IFN-γ], tumor necrosis factor-α [TNF-α]), hematological and nutritional parameters (hemoglobin, serum albumin), adverse drug reactions, and Medical Outcomes Study HIV Health Survey (MOS-HIV) scores were compared between groups. RESULTS: Compared with HAART alone, HAART plus Chinese herbal decoction produced more marked immune reconstitution. At 6-12 months, the combination group had higher CD4+ counts (37.58 ± 3.76 vs 30.25 ± 3.02 cells/µL, P < 0.0001), lower CD8+ counts (22.41 ± 2.25 vs 28.62 ± 2.65 cells/µL, P < 0.0001), and higher Th17 levels (2.26 ± 0.23 vs 1.89 ± 0.19 cells/µL, P < 0.0001). IFN-γ and TNF-α concentrations were significantly reduced, while hemoglobin (126.87 ± 12.68 vs 116.32 ± 11.65 g/L, P = 0.009), serum albumin (38.82 ± 3.84 vs 32.45 ± 3.26 g/L, P < 0.0001), and MOS-HIV scores (80.36 ± 8.07 vs 72.58 ± 7.25, P = 0.0026) were higher in the combination group. The incidence of adverse reactions was similar between the two groups. CONCLUSION: Adjunctive use of a spleen- and kidney-invigorating Chinese herbal decoction with HAART may help restore the balance of T-lymphocyte subsets, attenuate systemic inflammation, enhance immune function, and improve nutritional status in patients with acquired immune deficiency syndrome.