Table 7.
Randomized, placebo controlled trials on probiotics and prebiotics and HIV progression.
| Reference | Population, in- and exclusion criteria | Intervention and follow-up | Primary outcomes | Major findings | Conclusions |
|---|---|---|---|---|---|
| Trois 2007 [96] | Brazil, 77 children (42 receiving ART). | Daily B. bifidum and S. thermophilus (2.5 x 1010 CFU/ml) for two months. | CD4 count and diarrhea prevalence. | Increase in CD4 count, no reduction in diarrhea prevalence. | The candidate probiotic strains may increase CD4 count among children. |
| Land 2008 [104] | Italy, 57 ART naïve individuals. | Daily prebiotic 15 g or 30 g for 12 weeks1. | NK cell activity and CD4 cell activation. | Increased NK cell activity, reduced CD4 +/CD25+ cell activation and beneficial effect of intestinal flora. | Prebiotics may reduce HIV associated hyper-immune activation and enhance anti-viral response. |
| Anukam 2008 [97] | Nigeria, 24 ART naïve women | Daily L. rhamnosus GR-1 and L. reuteri RC-14 (>1.0 x 107 CFU/mL) for 4 weeks. | CD4 count and resolution of diarrhea | Increase in CD4 count and faster resolution of diarrhea. | The probiotics may increase the CD4 count and reduce the length of diarrheal episodes. |
| Kerac 2009 [105] | Malawi, 361 ART naïve children with malnutrition. | Daily Synbiotic Forte 20001 for 9 months. | Nutritional cure, mortality. | No difference in nutritional cure but trend towards reduced mortality. | Synbiotic may reduce mortality. |
| Lange 2009 [106] | Various countries, 340 ART naïve individuals. | Daily prebiotics, NAC, bovine colostrum, omega-3 PUFA’s and micronutrients for one year2. | CD4 count and viral load. | Increase in CD4 count, no decrease in viral load. | Intervention increases CD4 count and may delay the progression of HIV. |
CFU = colony forming unit, NAC = N-acetyl cysteine, NK = natural killer
1. Synbiotic included, Pediococcus pentosaceus, Leuconostoc mesenteroides, Lactobacillus paracasei ssp paracasei, and Lactobacillus plantarum (10¹¹ colony-forming units of bacteria total) and four prebiotic fermentable bioactive fibers (2.5 g of each per 10¹¹ bacteria) (oat bran [rich in β-glucans], inulin, pectin, and resistant starch).
2. Formula included short-chain Galactooligosaccharides (scGOS), long-chain Fructooligosaccharides (lcFOS) and Acidic Oligosaccharides from pectin hydrolysate (AOS) (ratio 9,1,10), NAC, bovine colostrum, omega-3 PUFA’s and micronutrients.