A study assessed the effects of probiotics in HIV-infected immunological non-responders (INRs) by analyzing gut immunity and microbiome in terminal ileum and sigmoid colon. The results appeared in the Journal of Acquired Immune Deficiency Syndromes.
This study consisted of clinical intervention with five-strain probiotic capsules (1.2 × 1010 CFUs/d) for 8 weeks in 20 patients. Eligible patients were INRs with CD4+ T-cell counts <400 cells/µL and plasma HIV RNA <50 copies/mL for more than 3.5 years. Colonoscopy with sampling data of gut biopsies from terminal ileum and sigmoid colon/fecal and blood sampling were performed before and following the study intervention. The investigators also assessed flow cytometry (cytokine production, immune activation, and exhaustion), ELISA (inflammation, microbial translocation, and enterocyte damage), and 16S rRNA sequencing analyses.
The researchers observed that in the terminal ileum, increased alpha diversity, increased abundance of Bifidobacterium, and decreased frequencies of IL-22+ CD4+ T cells. The increased abundance of Bifidobacterium in the terminal ileum correlated with increased fraction of CD4+ T cells in the same compartment (r = 0.54, P = 0.05) and increased CD4/CD8 ratio in peripheral blood (r = 0.49, P = 0.05). Overall, the researchers observed that probiotic intervention did not affect peripheral blood CD4 count, viral load, or soluble markers of inflammation and microbial translocation.
“Probiotics induced segment-specific changes in the terminal ileum but did not affect systemic CD4 counts in INRs. Further clinical studies are warranted to recommend probiotics to INRs,” the researchers concluded.
Keywords: HIV, immunological nonresponders, terminal ileum, sigmoid colon