Effects of Probiotics on Diarrhea and CD4 Cell Count in People Living With HIV: A Systematic Review and Meta-Analysis

Zhang, Xiaoli; Chen, Ming‐Hui; Geng, Shi-Tao; Yu, Juehua; Kuang, Yi‐Qun; Luo, Huayou; Wang, Kunhua

doi:10.3389/fphar.2021.570520

Cited by 11 publications

(13 citation statements)

References 41 publications

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“…Most studies assessing dietary interventions in children with HIV have been designed to assess the impact on malnourishment and diarrhea [ 28 , 29 ]. The information regarding the effects of dietary interventions to target inflammation and persistent immune defects in children with HIV is very scarce.…”

Section: Discussionmentioning

confidence: 99%

Targeting the Gut Microbiota of Vertically HIV-Infected Children to Decrease Inflammation and Immunoactivation: A Pilot Clinical Trial

et al. 2022

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Aims: Children with HIV exhibit chronic inflammation and immune dysfunction despite antiretroviral therapy (ART). Strategies targeting persistent inflammation are needed to improve health in people living with HIV. The gut microbiota likely interacts with the immune system, but the clinical implications of modulating the dysbiosis by nutritional supplementation are unclear. Methods: Pilot, double-blind, randomized placebo-controlled trial in which 24 HIV-infected on ART were randomized to supplementation with a daily mixture of symbiotics, omega-3/6 fatty acids and amino acids, or placebo four weeks, in combination with ART. We analyzed inflammatory markers and T-cell activation changes and their correlations with shifts in fecal microbiota. Results: Twenty-four HIV-infected children were recruited and randomized to receive a symbiotic nutritional supplement or placebo. Mean age was 12 ± 3.9 years, 62.5% were female. All were on ART and had HIV RNA < 50/mL. We did not detect changes in inflammatory (IL-6, IL-7, IP-10), microbial translocation (sCD14), mucosal integrity markers (IFABP, zonulin) or the kynurenine to tryptophan ratio, or changes in markers of the adaptive immune response in relation to the intervention. However, we found correlations between several key bacteria and the assessed inflammatory and immunological parameters, supporting a role of the microbiota in immune modulation in children with HIV. Conclusions: In this exploratory study, a four-week nutritional supplementation had no significant effects in terms of decreasing inflammation, microbial translocation, or T-cell activation in HIV-infected children. However, the correlations found support the interaction between gut microbiota and the immune system.

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Section: Discussionmentioning

confidence: 99%

Targeting the Gut Microbiota of Vertically HIV-Infected Children to Decrease Inflammation and Immunoactivation: A Pilot Clinical Trial

et al. 2022

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“…Interestingly, Bifidobacterium was also one of the main bacteria significantly reduced in END patients in our study. However, there is convincing evidence from multiple studies supporting the efficacy of probiotics in the treatment of multiple types of diarrhea ( Capurso and Koch, 2021 ; Kambale et al, 2021 ; Zhang et al, 2021 ). However, in reality, the efficacy of probiotics for diarrhea in inpatients is not ideal ( Allen et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Gut microbiome alterations in ICU patients with enteral nutrition-related diarrhea

Jiao

Zou

et al. 2022

Front. Microbiol.

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Enteral Nutrition-related Diarrhea (END) is an extremely common complication in Intensive Care Unit (ICU) patients. However, it is currently unclear whether the patient’s gut microbiota is disturbed. Our study aimed to explore the characteristics of gut microbiota changes in END patients. We divided ICU patients into no-END group (n = 7) and END group (n = 7) according to whether they had END, then stool samples were collected separately. The V3-V4 region of stool bacterial 16S rRNA gene was amplified by PCR and sequenced on an Illumina MiSeq PE300 platform. Microbiome data obtained by quality control were analyzed, including microbial community composition, diversity and gene function prediction.The results showed that the dominant gut microbiota in ICU patients who were given total enteral nutrition were Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria, and Verrucomicrobia. Bacterial richness and diversity in END patients were all significantly lower than those in no-END patients. In addition, END caused significant changes in bacterial composition. LEfSe found 34 biomarkers represented by Bacteroidetes and Subdoligranulum in the no-END group as well as 11 biomarkers represented by Enterococcus and Klebsiella in the END group. Finally, through PICRUST function prediction, we found that diarrhea led to abnormal changes in numerous KEGG pathways mainly related to immunity and metabolism. In short, ICU patients with END have severe gut dysbiosis, and our study provides a reliable experimental basis for the patient’s microbiota therapy.

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“…For instance, while improvements in CD4 lymphocyte count were reported in some studies [16][17][18], others had null findings [19][20][21]. Recently published meta-analyses focused on adults reported that probiotics had no effect on CD4 lymphocyte counts [22][23][24]. One metaanalysis of studies among children and adolescents only found that probiotics improved CD4 lymphocyte counts [25].…”

Section: Introductionmentioning

confidence: 99%

Effect of intake of probiotics and probiotic fermented foods on clinical outcomes among people living with HIV: A systematic review and meta‐analysis

Oyadiran,

Ogunlade,

Okusanya

et al. 2023

Tropical Med Int Health

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ObjectiveThe objective of the study was to determine the effect of probiotics and of probiotic‐fermented foods on CD4 T‐cell count, viral load, anaemia and body mass index (BMI) among people living with HIV (PLHIV).MethodsIn this article, we systematically reviewed the evidence on the influence of probiotic supplementation on CD4 lymphocyte count, viral load and anaemia among PLHIV on highly active antiretroviral therapy (HAART) and those who were HAART‐naive. Medical literature databases identified randomised trials and pre‐post studies of probiotic supplementation and HIV‐related outcomes, and random effects meta‐analysis was conducted.ResultsThe preponderance of the evidence suggests that probiotic supplementation only improved CD4 lymphocyte count modestly, with quantitatively greater impact among individuals who were HAART‐naive compared to HAART‐experienced individuals. Probiotic supplementation improved CD4 lymphocyte count by 53 cells/mm3 (95% CI: 22 to 85) from 18 studies. Probiotic supplementation however reduced haemoglobin concentration by −2.1 g/L (95% CI: −4.0 to −0.2). Although viral load remain unchanged in HAART‐experienced participants following probiotic supplementation, HAART‐naïve participants saw a decrease in viral load. There were too few studies on the impact of probiotic supplementation on viral load (N = 1).ConclusionProbiotic supplementation resulted in a modest increase in CD4 lymphocyte count among HAART‐naive individuals with no significant change observed among HAART‐experienced ones. Viral load and haemoglobin concentration also remained unchanged following probiotic supplementation. Further rigorous and well‐powered studies may evaluate the effect of probiotic supplementation on important clinical outcomes among PLHIV on HAART.

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Effects of Probiotics on Diarrhea and CD4 Cell Count in People Living With HIV: A Systematic Review and Meta-Analysis

Cited by 11 publications

References 41 publications

Targeting the Gut Microbiota of Vertically HIV-Infected Children to Decrease Inflammation and Immunoactivation: A Pilot Clinical Trial

Targeting the Gut Microbiota of Vertically HIV-Infected Children to Decrease Inflammation and Immunoactivation: A Pilot Clinical Trial

Gut microbiome alterations in ICU patients with enteral nutrition-related diarrhea

Effect of intake of probiotics and probiotic fermented foods on clinical outcomes among people living with HIV: A systematic review and meta‐analysis

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