Effects of Korean Red Ginseng combination therapy on HIV-infected patients treated with integrase strand transfer inhibitors

Background: Korean Red Ginseng (KRG) combined with antiretroviral therapy (ART) has shown benefits in the treatment of HIV-1-infected patients. Current guidelines recommend regimens containing integrase strand transfer inhibitors (INSTIs) as first-line treatment for these patients. The present study assessed the duration of effectiveness of ginseng combination therapy (GCT) in patients receiving INSTIs. Methods: This study included 58 HIV-1-infected patients previously untreated with monotherapy or two-drug combination therapy. Patients in the GCT (n = 26) group received ART plus KRG for 164 f 64 months, whereas patients in the control (n = 32) group received ART alone for 128 f 49 months. Subsequently, patients in these two groups received INSTI for 81 f 36 months and 68 f 26 months, respectively. Results: Before INSTI treatment, only one drug resistance mutation (DRM) was observed in the GCT group, compared with an overall resistance rate of 44.4 % in the control group (P < 0.001). The overall resistance rate was higher in the control than in the GCT group (9.5 % vs. 0.12 %, P < 0.001). During INSTI treatment, the resistance rate in the GCT group remained 0 % for over 5 years, but gradually decreased in the control group from 18.3 % to 13.9 % over 6 years, indicating that the between-group difference in resistance rate gradually decreased during INSTI treatment. Conclusion: The beneficial effects of KRG were well maintained for more than 20 years, including the INSTI treatment period.