Chinese herbal medicine for drug-induced liver injury in patients with HIV/AIDS: A systematic review of randomized controlled trials.
Journal article
Zhang, X-W., Li, J., Hou, W-B., Jiang, Y., Zheng, R-X., Xu, D-H., Shen, C., Robinson, N. and Liu, J-P. (2022). Chinese herbal medicine for drug-induced liver injury in patients with HIV/AIDS: A systematic review of randomized controlled trials. Integrative Medicine Research. 12 (1), p. 100918. https://doi.org/10.1016/j.imr.2022.100918
Authors | Zhang, X-W., Li, J., Hou, W-B., Jiang, Y., Zheng, R-X., Xu, D-H., Shen, C., Robinson, N. and Liu, J-P. |
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Abstract | To explore the effectiveness and safety of Chinese herbal medicine (CHM) for drug-induced liver injury (DILI) in patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). A systematic search was made of eight databases (Pubmed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP, Sinomed) and two trial registries (WHO ICTRP, ClinicalTrials.gov) from inception to September 2022. The effect size was presented as risk ratio (RR) or mean difference (MD) with their 95% confidence interval (CI). The Cochrane Risk of Bias and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tools were used for quality appraisal. Ten randomized controlled trials (RCTs) involving 732 participants were included. Comparing CHM alone with routine treatment, the CHM group showed lower aspartate aminotransferase (MD=-11.47 U/L, 95%CI[-13.05, -9.89], low certainty), lower alanine aminotransferase (MD=-2.68 U/L, 95%CI[-4.27, -1.08], low certainty), lower total bilirubin (MD=-4.31 mmol/L, 95%CI[-5.66, -2.96], low certainty), lower bilirubin direct (MD=-3.19 mmol/L, 95%CI[-3.87, -2.51], low certainty), and higher effective rate (assessed by symptoms and liver indicators) (RR=1.13, 95%CI[1.06, 1.20], low certainty). A significant difference was also found in CHM plus routine treatment versus routine treatment in the previous outcomes. No significant difference was found on helper T cells among these comparisons. Only one RCT reported safety of CHM and found no adverse reaction during the trial. CHM may improve the liver function indices and effective rate for HIV/AIDS patients with DILI. However, the sample size was small and quality was low. Larger-samples of high-quality trials are needed. [Abstract copyright: © 2023 Korea Institute of Oriental Medicine. Published by Elsevier B.V.] |
Keywords | Human immunodeficiency virus; Acquired immunodeficiency syndrome; Systematic review; Chinese herbal medicine; Drug-induced liver injury |
Year | 2022 |
Journal | Integrative Medicine Research |
Journal citation | 12 (1), p. 100918 |
Publisher | Elsevier |
ISSN | 2213-4220 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.imr.2022.100918 |
Publication dates | |
Online | 23 Dec 2022 |
Publication process dates | |
Accepted | 16 Nov 2022 |
Deposited | 27 Jan 2023 |
Publisher's version | License File Access Level Open |
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