Evidence-based narrative review of supplements with Panax ginseng in people living with HIV

Background: HIV remains a major global public health concern. People living with HIV (PLHIV), despite standard medical care, frequently experience fatigue, stress and sleep disturbances. Panax ginseng, a well-established medicinal herb in traditional Asian medicine, has gained scientific interest for its adaptogenic, antioxidant and neuroendocrine-modulating properties. Aim: To review current evidence on therapeutic benefits of supplements enriched with P. ginseng in PLHIV. Method: Relevant literature describing the potential role of P. ginseng in PLHIV was identified through searches of PubMed and Google Scholar and narratively synthesised. Results: Ginsenosides, the bioactive constituents, enhance cellular energy production, regulate hypothalamic-pituitary-adrenal axis activity and modulate pro-inflammatory pathways. These mechanisms improve physical endurance and stress resilience and reduce mental fatigue. Clinical and observational studies suggest improvements in fatigue, perceived stress, sleep parameters and overall well-being. In addition, long-term investigations of Korean red ginseng indicate potential immunological effects, including preservation of CD4+ T-cell counts, enhanced immune recovery when combined with antiretroviral therapy and delayed emergence of antiretroviral resistance. Multivitamin and multimineral co-supplementation may further support immune homeostasis and effects through synergistic antioxidant and metabolic mechanisms. Conclusion: Emerging evidence suggests that P. ginseng may serve as a complementary strategy to enhance quality of life in PLHIV by alleviating fatigue and supporting sleep quality. It also has potential benefits in preserving CD4+ T-cell counts. However, larger, well-designed trials are needed to validate these findings. Contribution: This narrative review suggests that P. ginseng may offer clinically meaningful adjunctive therapeutic effects in PLHIV.