Table 1 Main controlled studies in SIV and HIV with dietary interventions, prebiotics, postbiotics, symbiotics, and FMT
From: From dysbiosis to defense: harnessing the gut microbiome in HIV/SIV therapy
Population | Intervention | Study design and sample size | Outcomes | Ref |
|---|---|---|---|---|
Rhesus macaques | Vancomycin | 5 SIV + vancomycin 5 SIV control | Increased damage to GI tract epithelium | [60] |
Rhesus macaques | Vancomycin | 6 vancomycin before SIV challenge 6 control | Increased transmitter founder viruses after vancomycin | [61] |
Pigtail macaques | Probiotics | 5 (SIV + ART alone) 5 (SIV + ART + probiotics) | Increased GI tract CD4 + T-cell reconstitution | [63] |
Pigtail macaques | Probiotics + IL-21 | 5 (SIV + ART alone) 5 (SIV + ART + probiotics + IL-21) | Increased GI tract CD4 + T-cell reconstitution, transient Th17 increases | [64] |
Rhesus macaques | FMT | 6 FMT + SIV 6 control SIV | Increased Th17 cells | [65] |
Rhesus macaques | High-fat diet | 8 HFD + SIV 52 historical SIV controls | Increased SIV disease progression | [66] |
Pigtail macaque | High-fat diet | 7 historical SIV controls 5 HFD + SIV 3 HFD | Increased SIV disease progression | [67] |
Rhesus macaques | Butyrate | 6 (SIV + ART alone) 7 (SIV + ART + butyrate) | Slight increase in jejunal H3 acetylation and modest microbiome alterations | [68] |
PWH on ART | Fermented skimmed milk supplemented with Lactobacillus rhamnosus GG (108 cfu/mL), Bifidobacterium animalis subsp. Lactis B-12 (108 cfu/mL), and Lactobacillus acidophilus La-5 (107 cfu/mL) Duration: 8 weeks | Randomized, double-blind, placebo controlled trial N = 25 Probiotics: N = 12 Placebo: N = 7 Control: N = 6 | Mild D-dimer, CRP, and IL-6 reduction. No changes in microbial translocation (LPS, sCD14) or T-cell activation markers | [69] |
PWH on ART | Saccharomyces boulardii (two capsules three times a day or 6 × 107 living bacteria) Duration: 12 weeks | Randomized,d ouble-blind, placebo controlled trial N = 35 Probiotics: N = 19 Placebo: N = 16 | Decreased LBP No changes in inflammation markers or T-cell counts | [70] |
PWH diagnosed with CD4 < 350 cells/µL or AIDS starting ART | A synbiotic mixture of prebiotics, Saccharomyces boulardii, oligonutrients, essential amino acids, omega-3 fatty acids Duration: 48 weeks | Randomized, double-blind, placebo controlled trial N = 59 Synbiotics: N = 32 Placebo: N = 27 | No effects on primary (CD4 count, CD4/CD8 ratio) or secondary (T-cell activation, bacterial translocation, inflammation, or fecal microbiota structure) endpoints | [49] |
PWH on ART with CD4 < 500 cells/µL and < 50 cells/µL increase 6 months before enrolment | Lactobacillus casei Shirota Duration: 12 weeks | Randomized, double-blind, placebo controlled trial N = 45 • Probiotics: N = 23 • Placebo: N = 22 | No effects on CD4 count, CD4/CD8 ratio, T-cell activation, or sCD14 | [71] 714,353 |
PWH on ART on ART with CD4 > 200 cells/µL | Probiotic visbiome For weeks 2–4, one sachet orally daily For weeks 4–26, one sachet orally twice daily | Randomized, double-blind, placebo controlled trial N = 73 • Probiotics: N = 42 • Placebo: N = 31 | No effect on primary (sCD14) or secondary (markers of inflammation and gut permeability) enpoints | [72] |
PWH on ART and CD4 < 350/ counts µL despite virologic suppression | Probiotic visbiome Duration: 48 weeks | Randomized, double-blind, placebo controlled trial • Probiotics: N = 18 • Placebo: N = 10 | No effect on primary outcome (CD8 activation: HLA-DR + /CD38 + cells) or secondary (markers of inflammation, immune reconstitution, bacterial translocation, and gut permeability) endpoints CD4 + T-cell activation (HLA-DR +) increased | [73] |
PWH on ART and CD4 < 500 cells/µL | Probiotics: Lactiplantibacillus plantarum and Pediococcus acidilactici Prebiotics: Pectin, inulin, oat, acacia, maltodextrin polydextrose, and partially hydrolyzed guar gum Duration: 6 months | Randomized, double-blind, placebo controlled trial 71 patients • Probiotics: N = 21 • Prebiotics + Probiotics: N = 32 • Placebo: N = 18 | With synbiotics, slight increases of CD4 + counts and CD4/CD8 ratio, and decreased sCD14 | [74] |
PWH on ART and CD4/CD8 ratio < 1 | Fecal microbiota transplant from three selected donors | Randomized, double-blind, placebo controlled trial N = 29 patients • FMT: N = 14 • Placebo: N = 15 | Decreased in IFABP, increased alpha diversity, and increased Lachnospiraceae and Ruminococcaceae abundance No effects on CD4 counts, CD4/CD8 ratio, or other markers of inflammation and bacterial translocation | [75] |
MSM on ART | Supplemented Mediterranean diet (SMD) with extra-virgin olive oil and nuts | Randomized, open controlled trial N = 60, according to SMD • High adherence: N = 30 • Medium adherence: N = 20 • Low adherence: N = 8 | Improved lipid profiles and reduced immune activation with high adherence to SMD | [76] |