The Effects of Probiotic Supplementation on Immune Activation in HIV-Infected Patients on Antiretroviral Therapy

How Probiotics Help Reduce Inflammation Caused by Combination Antiretroviral Therapy

The life expectancy of people with human immunodeficiency virus (HIV) has dramatically improved with combined antiretroviral therapy (cART). Still, cART-treated patients have a higher mortality and morbidity rate than those of similar age but do not have detectable HIV antibodies involving cardiovascular, liver, and kidney diseases and some cancers. One possible cause is inflammation, as indicated by the heightened level of immune activation that persists in patients on cART, even if the presence of HIV is undetected or under control with medication. Some probable causes of this inflammation are ongoing HIV replication, coinfections, damage in the gastrointestinal (GI) tract, and microbial translocation (like when bacteria from the gut escape into the blood). Some people with HIV are now taking a probiotic supplement to reduce this inflammation. A probiotic is a type of bacteria that helps keep the gut healthy.

In this study conducted for 48 weeks, HIV-infected patients on cART with the undetectable presence of HIV-RNA (ribonucleic acid) in their blood were placed on probiotics supplementation to test the hypothesis that probiotics could reduce immune activation related to microbial translocation. 

(Note: RNA is the genetic material that contains information like how the virus reproduces itself.)

The Study Method on Probiotics for HIV Patients on cART

The study involved 31 participants — 11 healthy individuals and 20 HIV-infected patients on cART with persistent undetectable levels of HIV-RNA.

Only the HIV-infected patients were asked to take a daily dietary supplement with probiotics of multiple strains for 48 weeks, twice a day. Their immune activation was evaluated at baseline and 48 weeks after. They filled out a questionnaire at the end of the study to investigate their effects on bowel activity.

The healthy subjects did not consume probiotics and were used as controls of the treatment group to compare immune activation levels.

The Results

Inflammation and markers of microbial translocation were significantly reduced in HIV-positive patients with probiotic supplementation. Patients showed a clear and statistically significant reduction in their levels of immune activation on CD4 T-lymphocytes. After supplementation with a probiotic diet, their lipopolysaccharide-binding protein and high-sensitivity C-reactive protein plasma levels, biomarkers for HIV, settled to values comparable to those in the control group.

After probiotics treatment, all the patients reported beneficial effects like substantial improvement in digestion, reduced intestinal bloating, reduction of acute diarrhea episodes, or constipation.

No one disclosed any adverse events with the use of the probiotic supplement.

The Conclusion

These findings suggest that taking a probiotic supplement to cART may help improve immune function in the GI tract and reduce inflammation which could ultimately improve the prognosis for people with HIV.

Reference

Probiotics Reduce Inflammation in Antiretroviral Treated, HIV-Infected Individuals: Results of the “Probio-HIV” Clinical Trial

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