World Journal of AIDS, 2011, 1, 104-109
doi:10.4236/wja.2011.13016 Published Online September 2011 (http://www.SciRP.org/journal/wja)
Progress on Research for the Treatment of
HIV/AIDS with Traditional Chinese
Medicine in China
Jian Wang, Bi Yan Liang
Traditional Chinese Medicine Center for AIDS Prevention and Treatment, China Academy of Chinese Medicine Sciences, Beijing
China.
Received June 28th, 2011; revised August 1st, 2011; accepted August 8th, 2011.
ABSTRACT
The mortality rate associated with HIV/AIDS has decreased dramatically after highly active antiretroviral therapy
(HAART). However, issues such as viral reservoirs, drug resistance and side effects have led to a significant crisis in
the management of HIV/AIDS. It has become evident that HAART does not offer a complete solution to the problem.
Therefore, additional and alternative therapeutic strategies urgently need to be explored. Traditional Chinese medicine
(TCM) is one of the mainstays o f comp lemen tary and alterna tive medicin e, and its use has arou sed in creasing a tten tion .
This paper reviews the recent progress in the use of TCM, from single herbs, herbal ingredients, compound Chinese
herbal medicine, acupuncture and medical care, for the treatment of HIV/AIDS in China. We also review evaluation
systems that assess the efficacy of TCM.
Keywords: HIV/AIDS, Traditional Chinese Medicine (TCM)
1. Introduction
Acquired immunodeficien cy syndrome (AIDS) is a set of
symptoms and infections that are life threatening and
result from damage to the human immune system. It is
caused by the human immunodeficiency virus (HIV), and
was first identified in 1981. It is the fourth biggest killer
worldwide and the most quickly spreading disease of the
century [1,2]. It is now 26 years since the first case of
AIDS was reported in 1985 in China. According to re-
cent reports from the Ministry of Health in China [3], by
the end of October 2010, the cumulative total of reported
HIV-positive cases was 370,393, including 132,440
AIDS cases and 68,315 recorded deaths. The AIDS epi-
demic in China is rising, and prevention and treatment
are major concerns.
Highly active antiretroviral therapy (HAART) is very
effective in suppressing viral replication and has led to a
significant reduction in the mortality rate of the disease,
an increase in the life expectancy of HIV/AIDS patients,
and an improvement in quality of life (QoL) of these
patients [4-6]. However, issues such as, viral reservoirs,
drug resistance, high dosage and drug costs, have led to a
significant crisis in the management of HIV/AIDS, par-
ticularly in developing nations, where there is the great-
est need [7-9]. It has become evident that HAART does
not offer a complete solution to the problem. Therefore,
additional and alternative anti-HIV therapeutic strategies
urgently need to be explored [10]. Traditional Chinese
medicine (TCM) is one of the mainstays of complemen-
tary and alternative medicine, and its use has increased
[11]. Generally, people with HIV/AIDS use TCM for
four main reasons: to enhance their immune function, to
treat symptoms, to improve their QoL, and to reduce side
effects related to medications [12,13]. The objective of
this article is to review the recent use of TCM in HIV/
AIDS in China.
According to the review by Wang Jian [14], research
on TCM for the treatment of HIV/AIDS has gone
through three stages: a perceptual stage, a preliminary
study stage, and the stage of gradually standardizing and
improving treatment.
2. Chinese Herbal Medicine
Treatment of HIV/AIDS remains inadequate because the
HIV virus mutates rapidly, appropriate animal models

Progress on Research for the Treatment of HIV/AIDS with Traditional Chinese Medicine in China105
are lacking, development of a vaccine has great difficul-
ties and existing anti-viral treatments cannot fundamen-
tally destroy the virus. There may be, therefore, a poten-
tial role of TCM in the treatment of HIV/AIDS. After
years of clinical applications, it should be possible to
develop effective drugs from the numerous existing na-
tural traditional medicines for the treatment of HIV/
AIDS. On this basis, research on natural medicines that
suppress HIV/AIDS is currently being carried out all
over the world. In particular, Professor Lv, Professor
Wang and colleagues of the China Academy of Chinese
Medicine Sciences, Professor Luo of Kunming Institute
of Botany, and other scholars have been performing re-
search in this area for the past 20 years [15].
There ar e three asp ects to the res earch on TCM for th e
treatment of HIV/AIDS: firstly, single herb s are screened;
secondly, the active herbal ingredients are studied, and
thirdly, compounds of Chinese herbal medicine are stud-
ied.
2.1. Research on Single Herbs
In the past 20 years, many scholars who conducted re-
search on Chinese herbal medicines found that a variety
of traditional medicine to some extent had inhibitory
effects on HIV and improved immune function. Thou-
sands of herbs have been screened for anti-HIV activity.
Over 140 kinds of herbs have been shown to have in-
hibitory effects on HIV. Of those herbs, more than 20
species showed strong anti-HIV activity [15,16] (Table
1). Rebuilding the immune system is crucial because
AIDS patients have severely impaired immune function.
Almost all tonics used in TCM had varying degrees of
effectiveness in enhancing immune function [17,18].
2.2. Research on Herbal Ingredients (Table 2)
At present effective extracts of herbal compounds in-
clude 15 polysaccharides, seven alkaloids, 29 flavonoids,
29 terpenes, eight coumarins, eight tannic acids, four
plant hemagglutinins, four quinolones, two peptides, and
various others [19-21]. The mechanisms of action in-
clude the competitive and non-competitive inhibition of
reverse transcriptases, proteases, and interference with
the viral entry into cells. These pr omising results support
the search for further Chinese herbal medicines that are
effective anti-HIV agents.
2.3. Clinical Studies of Compound Chinese
Herbal Medicine
The first patent approved by the State Food and Drug
Administration (SFDA) was for Tangcao tablets, which
are used to alleviate the signs and symptoms of HIV/
AIDS. Eleven compounds have obtained clinical appro-
val (Aiqikang granule, Keaite granule, Fufangsanhuang-
san, Qiankunning tablets, Aining particles, Aifukang
granule, Fufang SH, Quduzengning granule, Aikefuz-
heng tablets, Aifuping granule, Chuankezhi injection), of
which five relatively matured compounds (Qiankunning
tablets, Keaite granule, Fufangsanhuangsan, Aining par-
Table 1. Single herbs that have anti-HIV effects.
Single Herbs Effect
Licorice, Astragalus, Trichosanthin, Cortex Mori, Lithospermum, Chinese Violet, Polygonum Cuspidate, Scutellaria, Salvia,
Bupleurum, Croton, Radix Rhapontici, Prunella Vulgaris, Honeysuckle, Epimedy, Cassia, Dark Plum,Chrysanthenum
Indicum, etc. Anti-HIV activity
Table 2. Constituent herbal ingredients with anti-HIV activities.
Herbs Ingredients Herbs Effect
polysaccharides Seaweed, Indocalamus, Trihexyphenidyl Grass, Mushrooms,
Prunella Vulgaris, Viola, Eclipta, Aloe, etc. Block HIV virus and cell adsorption
protein Trichosanthes, Bitter Melon, Musk, Pink, etc. Inhibition of ribosom al RNA to d estroy protein
synthesis of normal chrom osom e
alkaloids Tripterygium, etc. Anti-HIV activity
flavonoids Snow Lotus, Narrow-Leaf Nettle, etc. Interfere with the virus and cell integration
coumarin Poon, Musk Root, Narrow Every Celery, Coriander, etc. HIV reverse transcriptase inhibitors
lignans Cairica, Millettia, Myrobalan, etc. Anti-HIV-1 replication activity
plant haemagglutinin Skullcap, Turks Rose, Cornflower, Licorice, etc. Anti-HIV activity
terpenes Andrographis, Annona, Crot on, Almond Shells, Fungus,
Schisandra, Hawthorn, Cynomorium, Horse Chestnut, etc. Multiple targets for HIV replicati o n cyc l e

Progress on Research for the Treatment of HIV/AIDS with Traditional Chinese Medicine in China 106
ticles, Chuankezhi injection) are still in clinical trials.
Two randomized controlled trials (RCTs) have re-
ported that using Chinese herbs (Qiankunning capsules
and Compound Sanhuangsan) for 6-7 months signifi-
cantly reduced viral loads compared with the control
group [22,23]. Three RCTs have reported that the use of
Chinese herbs (Tangcao tablets, Aining Granule and ZY-
4) for 6-12 months stabilized and promoted immune
function compared with the control group [24-26].
Clinical studies [22-26] have shown that TCM could
improve the signs and symptoms of HIV/AIDS (such as
fatigue, diarrhea, fever, and rash) and QoL, and have
some effect in increasing and stabilizing immune func-
tion, but the effect on viral load was not obvious. As the
sample sizes of the current clinical studies were small
and observation times were short, future studies will n e ed
to address these issues. The use of the RCT method of
clinical trials would also yield results that are more sci-
entific and objective.
Nine RCTs [27-35] have reported that using Chinese
herbs had a positive effect on HIV/AIDS-related diseases,
such as oral candidiasis, peripheral neuropathy, pneumo-
nia and diarrhea, and could improve QoL. However,
there were some problems with the overall quality of
research, which was not high, and study designs were
defective (e.g., small number of cases, random applica-
tions, short times of observation, blind implementation).
Those problems affected the reliability o f the con clusions
drawn from the studies. Therefore, the results of those
studies will need to be further verified in a large sample,
and with more rigorous and extensive clinical research.
TCM is becoming widely acknowledged abroad for its
medicinal benefits. Yang et al. [36] analyzed the dy-
namic observation results of CD4+ and CD8+ T lympho-
cytes from 13 HIV/AIDS patients in Tanzania, who have
survived for more than 10 years. The analysis showed
that long-term TCM intervention was effective in in-
creasing and maintaining CD4+ T lymphocytes, and ac-
tivating or adjusting CD8+ lymphocytes. TCM was also
effective in delaying the progression of AIDS, prolong-
ing longevity and had a long-term therapeutic effect on
AIDS. Huang et al. [37] analyzed the effectiveness of
TCM in the treatment of 729 HIV/AIDS p atients in Tan-
zania. They showed that TCM could improve symptoms
and immune function, and the effect was significant in
CD4 < 200 cell/mm3.
The composition of TCM is complex and diverse, and
it is difficult to identify the mechanisms underlying its
effects. Thus, convincing scientific data are lacking.
Therefore, greater effort is needed for studies on the ac-
tive ingredients, and in determining their composition,
structure, mechanism, and effective dose. In order to
achieve the efficacy of western medicines, purified active
ingredients are required.
3. Clinical Studies of Acupuncture
Clinical data [38] show that acupuncture can enhance the
immune system, has anti-viral effects, relieve symptoms
of HIV/AIDS and prolong survival time, so that patients
can maintain long-term survival despite infected status.
Moxibustion treat ment also initially sh owed potential for
treating HIV/AIDS. It had features of relieving symp-
toms quickly without side effects, and was easily per-
formed at low cost.
Four RCTs have reported that moxibustion, with main
points Guanyuan (CV4), Shenque (CV8), Zusanli (ST36),
Tianshu (ST25), are effective for AIDS-associated diar-
rhea [39-42].
4. Medical Care
In order to implement the State Council “Four Frees and
One Care” policy, a pilot project named the “National
Free Treating HIV/AIDS with TCM Program” was
launched by the State Administration of Traditional Chi-
nese Medicine on August 2004. By the end of October
2010, 14,244 HIV/AIDS patients have been treated with
TCM in 19 provinces. Wang et al. [43] collected data
from 8946 HIV/AIDS patients treated with TCM, and the
results showed that TCM treatment was effective in re-
lieving symptoms such as fever, asthenia, shortness of
breath, loss of appetite, diarrhea, and skin rashes, of
which the improvement of asthenia was the most signifi-
cant. The CD4 count in the asymptomatic period which
treated with TCM decreased by an average rate of about
12/mm3/year, less than the average natural rate of 30 -
50/mm3/year[44], whereas that of the AIDS patients
which treated with HAART and TCM increased with
time. TCM therapy is able to enhance and stabilize the
immune function, improve the symptoms and signs, and
improve the QoL.
5. Efficacy Evaluation Standards System
In order to reflect clinical efficacy of treatment of HIV/
AIDS with TCM scientifically and objectively, evalua-
tion criteria have been revised by the State Administra-
tion of Traditional Chinese Medicine in 2007. Using
evidence-based medicine methods, they analyzed clinical
data obtained from literature and pilot projects carried
out since 2004. Expert panels were convened several
times. Having collected clinical observations of 512
cases in eight consecutive months in five areas with a
high incidence of AIDS (Henan, Yunnan, Guangdong,
Anhui and Beijing), "Outcome Assessment System of
Treating HIV/AIDS with TCM" was formed. The system
evaluated treatment from the perspective of patients, with
self-reporting of symptoms, and utilized patient-reported

Progress on Research for the Treatment of HIV/AIDS with Traditional Chinese Medicine in China107
outcomes (PRO) measurements, including the WHO-
QOL-HIV, QoL scale localization studies, clinical stag-
ing of disease, and syndrome and evaluation measures.
The main difference of evaluation criteria, between the
current system and previous systems, was not only con-
fined to laboratory indicators, but also included QoL,
survival time and response to treatment. It has been ini-
tially approved.
6. Conclusions
The unique advantages of treating HIV/AIDS with TCM
are that it is people-oriented, ho listic, and the treat ment is
based on syndrome differentiation. It is characterized by
low toxicity, persistent effects, enhancement of immune
function, improvement of symptoms and QoL and re-
ducing the incidence of opportunistic infections. Al-
though considerable progress has been made in the
treatment of HIV/AIDS with TCM, there have been cer-
tain problems. Firstly, the experimental studies and
clinical applications have focused on developing Chinese
medicine compounds, single herbs and effective compo-
nents, more focusing on anti-HIV functions and the im-
mune system. There has been a lack of the basic theory
of TCM, separating from the holistic concepts and treat-
ment based on syndrome differentiation. Secondly, there
is a key problem in clarifying the effectiveness of treat-
ing HIV/AIDS with TCM. It is not known which aspects
and disease stages of HIV/AIDS could be effectively
treated with TCM. Furthermore, whether various evalua-
tion indicators can be combined and agreed standards can
be established remains to be resolved, and it remains
difficult to determine the actual role of TCM using the
existing immune parameters. Thirdly, there is no uniform
standard of clinical diagnosis and treatment of HIV/
AIDS with TCM; its application is still based on the
treatment of other diseases. In view of this, we should
collaborate with clinicians to formulate national unified
efficacy standards for treating HIV/AIDS with TCM. We
need to screen Chinese medicine compounds further,
including single herbs and effective components of mul-
tiple agents, and look for treatment strategies that are
suitable for China. At the same time, research on the
standardization of anti-HIV medicine, and into deter-
mining the active components of Chinese medicine and
their structure, should be advanced in order to maximize
the potential benefits of TCM.
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