Probiotic Visbiome improves gut barrier function in patients with HIV

“Probiotic supplementation improved the physical and immunological integrity of the intestinal mucosal barrier in HIV-1-positive patients being treated with antiretroviral therapy, according to new research.


Probiotics for HIV

The researchers sought to evaluate the effects of a high potency multistrain probiotic — marketed in the U.S. as Visbiome (ExeGi Pharma) and Vivomixx in Europe — on intestinal immunity in HIV-1 patients on antiretroviral therapy. They performed a sub-study of a pilot longitudinal, non-randomized, single arm trial of 10 patients who received the supplement twice daily for 6 months between May 2014 and February 2015. All patients were white men with a median age of 42 years, and were all on antiretroviral therapy for a median of 6 years.

The investigators concluded that these findings demonstrate the potential benefits of probiotic supplementation for restoring mucosal intestinal barrier integrity in HIV-1 patients treated with antiretroviral therapy, but emphasized that the results should not be generalized to all probiotics, as “it is the probiotic strain itself which determines the efficacy of the product and hence the associated findings.” This is especially important in immunocompromised patients, they added.”



Do Friendly Bugs Improve Immune Function?

CROI 2012 Oral Presentation #95 . Probiotic
Supplementation of ARV Treatment during SIV Infection of Pigtail Macaques
Results in Enhanced GI Tract CD4+ T Cell Frequency and Immunological Function
During progressive
HIV/SIV (simian immune defficiency virus in monkeys) infections, damage to the GI tract leads to microbial translocation,
which may contribute to chronic immune activation and disease progression.
This study treated
chronically SIV-infected pigtail macaques monkeys (PTM) with probiotics (brand name:
Culturelle) in combination with ARV treatment, and compared to chronically SIV-infected
PTM treated with ARV alone. Combination ARV therapy included 30mg/kg PMPA (a
nucleoside that has been extensively used in SIV studies), 30mg/kg
emtricitabine (FTC) (once daily, s.c.), and 120mg L812, 50mg L564 (twice daily,
oral integrase inhibitors) for an average of 162 days.
The study team found
that, compared to PTM treated with ARV alone, animals given probiotics and ARV
had enhanced reconstitution of CD4+ T cells in the colon (almost double the CD4
cell counts attained by the ARV alone group) . Furthermore, probiotic treatment
decreased the activation of CD4+ T cells in the colon and increased the overall
functionality of colon CD4+ T cells as measured by multifunctional cytokine
production, with indications of enhanced mucosal immunity.
Although this was a
monkey study, the presenter hinted at the possibility of expecting similar
results in humans infected with HIV. 
Since probiotics do not colonize the GI track, they need to be dosed
daily or frequently, however.