HIV infection

Overview

Background

HIV infection is a chronic disease and estimates suggest that over 100,000 people in the UK are infected (HPA 2011; HPA 2009). About 54% of those infected acquire HIV heterosexually, 42% through sex between men, and the rest through, for example, injecting drug use, mother-to-child transmission and blood product. (HPA 2010.)

HIV infection has a variable and unpredictable course, with a wide range of potential complications, rates of progression, and survival. Some patients remain free of serious symptoms and complications until they have reached an advanced stage of immunosuppression, while others can experience debilitating malaise and fatigue or frequent non-life threatening complications throughout their infection (Wood 1997). Peripheral neuropathy is one of the most common neurological complications of human immunodeficiency virus (HIV) infection, and diarrhoea is another common symptom (Anastasi 2011).

Treatment includes combination antiretroviral drugs to control the HIV infection, other drugs to help relieve symptoms such as pain and antimicrobials for secondary infections.

Clincal research

Two randomised controlled trials found that there could potentially be synergistic effects of acupuncture and relaxation, one for treating GI symptoms and one to improve quality of life. (Chang 2011; Chang 2007) Another randomised controlled trial found that acupuncture resulted in an improvement in peripheral neuropathy in patients with HIV/AIDS. (Shiflett 2011) The results of two open studies also suggest a positive effect of acupuncture on neuropathic pain (Phillips 2004; Galantino 1999), while other open and quasi-controlled studies have found that acupuncture may help with facial pain (Zhou 2008), diarrhoea (Anastasi 2003) and sleep disturbance (Phillips 2001). Finally, one study found that moxibustion appeared to increase total lymphocyte count. (Wang 2007)

Potential mechanisms

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.

Research has shown that acupuncture treatment may specifically help to relieve symptoms of HIV infection by:

• Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the analytical brain, which is responsible for anxiety and worry (Hui 2010; Hui 2009);
• Increasing the release of adenosine, which has antinociceptive properties (Goldman 2010);
• Improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling;
• Reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007)