Acupuncture for HIV/AIDs and its complications: A systematic review and meta-analysis

Introduction

Human immunodeficiency virus (HIV) has spread globally. Both acquired immune deficiency syndromes (AIDs) and its complications pose a serious threat to human health. Acupuncture has been reported as a complement to Western medicine for relieving HIV/AIDs-related symptoms, but systematic reviews on acupuncture for HIV/AIDs and its complications are lacking.

Methods

Six databases were searched for both randomized controlled trials (RCTs) and quasi-randomized controlled trials (q-RCTs) using any types of acupuncture for HIV/AIDs and their complications. The primary outcome included global clinical efficacy assessment (i.e., number of patients with improving symptoms), pain, numbness intensity, sleep quality, depression and severe adverse events (i.e., death or hospitalization), and the secondary outcomes included other HIV/AIDs related outcomes such as immune response markers (CD4+ T-lymphocyte count), biochemical markers, functional outcomes (quality of life, level of physical activity), follow-ups and other adverse outcomes such as nausea, vomiting, and fever. Two reviewers independently applied the inclusion criteria, extracted data and evaluated the risk of bias in the included trials. This systematic review is registered with PROSPERO (CRD42020214490).

Results

Sixteen trials (thirteen RCTs and three q-RCTs) on complications including peripheral neuropathy, gastrointestinal symptoms, inflammation, insomnia and depression were included. The results revealed that manual acupuncture plus moxibustion (RR 1.58, 95 % CI [1.10, 2.28], 1 RCT, n = 60), manual acupuncture only (RR 1.56, 95 % CI [1.20, 2.03], 1 RCT, 1 q-RCT, n = 175) or auricular acupuncture (RR 2.02, 95 % CI [1.35, 3.02], 1 RCT, n = 72) could improve the symptoms in HIV-infected patients; reduce pain and numbness intensity, reduce score of Hamilton Depression Scale andimprove sleep quality. Meanwhile, acupuncture appeared to improve biochemical indicators whilst not increasing the drop-out rate, recurrence, mortality or adverse events. The quality of evidence was moderate quality for sleep quality; low quality for global clinical efficacy assessment rate, pain and numbness intensity; and very low quality for pain and depression.

Conclusions

Acupuncture may be an effective and safe intervention for HIV/AIDs related complications, including peripheral neuropathy, inflammation, insomnia and depression. However, the low quality of the evidence limits the relevance of those findings.