The effect of oral probiotics on CD4 count in patients with HIV
infection undergoing treatment with ART who have had immunological
failure
Abstract
Introduction: Probiotics are live microorganisms that, when administered
in appropriate colonies, can delay the destruction of the immune system
and contribute to the maintenance of immunity in HIV patients.
Probiotics play an important role in stimulating natural killer T cells,
strengthening the functional gut barrier, and reducing systemic
inflammation. Methods: This study was a randomized double blind clinical
trial involving 30 patients treated with ART who had experienced
immunological failure despite HIV viral suppression. Patients were
divided into two equal groups of 15, the first group received 2
probiotic capsules daily with a colony count of 10⁹CFU per capsule
containing seven strains ,after three months they were examined for CD4+
counts by flow cytometry, after a one month washout period the
participants who had received probiotics were switched to placebo, and
the participants who had received placebo were given probiotics for
three months, and they were examined for CD4+ counts seven months after
the start of the study. Results: In the first group, administration of
the placebo resulted in a decrease in CD4 count in the first three
months (from 202.21 to 181.79, p-value < 0.001),which may be
due to the natural history of the disease. After probiotics
administration, CD4 count increased significantly (from 181.79 to
243.86, p-value < 0.001). Overall, after 7 months of study,
there was a significant increase in the mean CD count from 202.21 to
243.86 (p-value < 0.001). In the second group, administration
of probiotics in the first three months of the study resulted in a
significant increase in the mean CD4 count (from 126.45 to 175.73,
p-value < 0.001).Termination of treatment with probiotics
resulted in a significant decrease (from 175.73 to 138.9, p-value
< 0.001)but overall the CD4 count at the end of the study was
significantly higher than at baseline (p-value < 0.001).