Randomized pilot trial of a synbiotic dietary supplement in chronic HIV-1 infection

Authors: Marco Schunter , Hiutung Chu , Timothy L Hayes , Delandy McConnell, Sean S Crawford , Paul A Luciw , Stig Bengmark , David M Asmuth4 , Jennifer Brown4 , Charles L Bevins , Barbara L Shacklett, and J William Critchfield.

Published: BMC Complementary and Alternative Medicine, 2012.

Method and selection

The study was conducted in vivo, involving human participants.

Design: This was a randomized, double-blind, placebo-controlled study.

Treatment:  4-weeks of synbiotic formulation (Synbiotic 2000) was provided each day, versus a fiber-only placebo formulation.

Where and when: The Center for AIDS Research, Education, and Services (CARES) in Sacramento, CA, between the dates of June 2008 and September 2009.

Sample size: 38 subjects.

Sample criteria: HIV seropositive, 2) adult female, 3) currently taking antiretroviral medications, and 4) blood CD4 count >200 cells/μl. Exclusion criteria included: 1) Acquired immune deficiency syndrome (AIDS)-defining conditions, 2) current use of oral antibiotics, and 3) presence of inflammatory bowel disease or other known GI pathology.

Analysed material: Recordkeeping sheet, stool sample and blood sample.

Results and indicative results

Results

The synbiotic formulation resulted in significantly elevated levels of supplemented probiotic bacterial strains in stool, with the colonizations being positively correlated with each other.

Treatment of HIV-1 infected subjects with a synbiotic for 4 weeks can successfully augment the levels of probiotic species in the gut. (s.14).

Indicative results and Further research

Synbiotic treatment for 4 weeks can successfully augment the levels of probiotic species in the gut during chronic HIV-1 infection. Associated changes in microbial translocation appear to be absent, and markers of systemic immune activation appear largely unchanged. These findings may help inform future studies aimed at testing pre- and probiotic approaches to improve gut function and mucosal immunity in chronic HIV-1 infection.

The data can help provide a foundation for future studies aimed at optimizing synbiotic formulations and treatment schedules in HIV patients. With this information it can then be possible to determine whether synbiotics can improve gut barrier function and reduce chronic immune activation in this population. (s14).

Full research study