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



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Sainz, Talía and Diaz, Laura and Rojo, David and Clemente, María Isabel and Barbas, Coral and Gosalbes, María José and Jiménez Hernández, Nuria and Escosa, Luis and Guillen, Sara and Ramos Amador, José Tomás and Muñoz Fernández, María Ángeles and Navarro, María Luisa and Mellado, María José and Serrano Villar, Sergio (2022) Targeting the Gut Microbiota of Vertically HIV-Infected Children to Decrease Inflammation and Immunoactivation: A Pilot Clinical Trial. Nutrients, 14 (5). p. 992. ISSN 2072-6643

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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.

Item Type:Article
Uncontrolled Keywords:HIV; inflammation; immunoactivation; microbiota; children
Subjects:Medical sciences > Medicine > Gastroenterology and Hepatology
ID Code:73359
Deposited On:07 Jul 2022 15:26
Last Modified:08 Jul 2022 07:29

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