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

Lei Zhang¹, Yili Ren^2,*, Zhan Zhang¹, Beibei Zhang³, Chenkai Xu⁴

1. Department of Infectious Diseases/Department of hepatology I, Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang, China
2. Department of Geriatrics II, Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang, China
3. Department of Oncology, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China
4. Department of Cardiology, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China

*Corresponding Author: Yili Ren; E-mail: rc08988@outlook.com

Abstract
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.
Keywords: Acquired Immune Deficiency Syndrome, Highly Active Antiretroviral Therapy, Chinese Traditional Medicine, T Lymphocyte Subsets, Nutritional Status