Gut microbiota: A novel target for traditional Chinese medicine in the treatment of HIV/AIDS immunological non-responders

Despite effective antiretroviral therapy (ART), HIV/AIDS patients often experience viral suppression without full recovery of CD4 ⁺ T lymphocyte (CD4 cells) counts, a condition referred to as immunological non-responders(INRs). INRs face significant health risks, with the underlying pathogenesis remaining unclear and no established effective treatments, making it a critical challenge in HIV/AIDS management and prevention. Recent studies have found that INRs exhibit significant disruptions in gut microbiota composition. Abnormal immune activation, cytokine imbalance, and cell pyroptosis resulting from gut microbiota dysbiosis may contribute to INRs in individuals with HIV/AIDS. Traditional Chinese medicine (TCM) offers potential immune-enhancing benefits and has been widely applied in the treatment of INRs. Targeting gut microbiota and elucidating the scientific mechanisms through which TCM may prevent and treat INRs could enhance therapeutic outcomes. Taking the gut microbiota as an entry point, this article reviews the relationship between gut microbiota and TCM, the association between gut microbiota and INRs, the mechanisms by which gut microbiota dysbiosis leads to INRs development, and how TCM regulates gut microbiota to prevent and manage INRs. This review offers novel insights into the prevention and treatment of INRs through TCM, potentially fostering the development of new therapeutic strategies.