title: Synbiotic therapy decreases microbial translocation and inflammation and improves immunological status in HIV-infected patients: a double-blind randomized controlled pilot trial.
abstract: BACKGROUND
  HIV-infection results in damage and dysfunction of the gastrointestinal system. HIV enteropathy includes pronounced CD4+ T-cell loss, increased intestinal permeability, and microbial translocation that promotes systemic immune activation, which is implicated in disease progression. A synbiotic is the combination of probiotics and prebiotics that could improve gut barrier function. Our study goal was to determine whether the use of a synbiotic, probiotics or a prebiotic can recover immunological parameters in HIV-infected subjects through of a reduction of microbial translocation and pro-inflammatory cytokine production.
  
  
  METHODS
  A randomized, double-blind controlled study was performed; twenty Antiretroviral treatment-naïve HIV-infected subjects were subgrouped and assigned to receive a synbiotic, probiotics, a prebiotic, or a placebo throughout 16 weeks.
  
  
  RESULTS
  We had no reports of serious adverse-events. From baseline to week 16, the synbiotic group showed a reduction in bacterial DNA concentrations in plasma (p = 0.048). Moreover, the probiotic and synbiotic groups demonstrated a decrease in total bacterial load in feces (p = 0.05). The probiotic group exhibited a significant increment of beneficial bacteria load (such as Bifidobacterium; p = 0.05) and a decrease in harmful bacteria load (such as Clostridium; p = 0.063). In the synbiotic group, the CD4+ T-cells count increased (median: +102 cells/μL; p = 0.05) and the level of Interleukin 6 cytokine decreased significantly (p = 0.016).
  
  
  CONCLUSIONS
  Our study showed a significant increase in CD4+ T lymphocyte levels in the synbiotic group, which could delay the initiation of antiretroviral therapy and decrease costs in countries with limited resources.
authors.affiliation: HIV Unit Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara, Calle Hospital 278, Colonia Alcalde Barranquitas, Guadalajara, Jalisco, 44280, Mexico.
authors.forename: Luz A
authors.initials: LA
authors.lastname: González-Hernández
authors.forename: Luis F
authors.initials: LF
authors.lastname: Jave-Suarez
authors.forename: Mary
authors.initials: M
authors.lastname: Fafutis-Morris
authors.forename: Karina E
authors.initials: KE
authors.lastname: Montes-Salcedo
authors.forename: Luis G
authors.initials: LG
authors.lastname: Valle-Gutierrez
authors.forename: Ariel E
authors.initials: AE
authors.lastname: Campos-Loza
authors.forename: Luis Fermin
authors.initials: LF
authors.lastname: Enciso-Gómez
authors.forename: Jaime F
authors.initials: JF
authors.lastname: Andrade-Villanueva
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D018988:Bacterial Translocation; D001644:Bifidobacterium / Q000145:classification / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification; D018791:CD4 Lymphocyte Count; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D004269:DNA, Bacterial / Q000097:blood; D018450:Disease Progression; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D019053:HIV Enteropathy / Q000178:diet therapy* / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007413:Intestinal Mucosa / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D052201:Lacticaseibacillus rhamnosus / Q000145:classification / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification; D008297:Male; D008800:Mexico; D010865:Pilot Projects; D056692:Prebiotics / Q000009:adverse effects; D019936:Probiotics / Q000009:adverse effects / Q000302:isolation & purification; D011788:Quality of Life; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016207:Cytokines; D004269:DNA, Bacterial; D056692:Prebiotics