National Health Service, England, UK.
Faculty of Clinical Sciences, Olabisi Onabanjo University, Ogun State, Nigeria.
Trop Med Int Health. 2024 Feb;29(2):113-127. doi: 10.1111/tmi.13955. Epub 2023 Dec 19.
The objective of the study was to determine the effect of probiotics and of probiotic-fermented foods on CD4 T-cell count, viral load, anaemia and body mass index (BMI) among people living with HIV (PLHIV).
In this article, we systematically reviewed the evidence on the influence of probiotic supplementation on CD4 lymphocyte count, viral load and anaemia among PLHIV on highly active antiretroviral therapy (HAART) and those who were HAART-naive. Medical literature databases identified randomised trials and pre-post studies of probiotic supplementation and HIV-related outcomes, and random effects meta-analysis was conducted.
The preponderance of the evidence suggests that probiotic supplementation only improved CD4 lymphocyte count modestly, with quantitatively greater impact among individuals who were HAART-naive compared to HAART-experienced individuals. Probiotic supplementation improved CD4 lymphocyte count by 53 cells/mm (95% CI: 22 to 85) from 18 studies. Probiotic supplementation however reduced haemoglobin concentration by -2.1 g/L (95% CI: -4.0 to -0.2). Although viral load remain unchanged in HAART-experienced participants following probiotic supplementation, HAART-naïve participants saw a decrease in viral load. There were too few studies on the impact of probiotic supplementation on viral load (N = 1).
Probiotic supplementation resulted in a modest increase in CD4 lymphocyte count among HAART-naive individuals with no significant change observed among HAART-experienced ones. Viral load and haemoglobin concentration also remained unchanged following probiotic supplementation. Further rigorous and well-powered studies may evaluate the effect of probiotic supplementation on important clinical outcomes among PLHIV on HAART.
本研究旨在确定益生菌和益生菌发酵食品对接受高效抗逆转录病毒治疗（HAART）和未接受 HAART 的艾滋病毒感染者（PLHIV）的 CD4 计数、病毒载量、贫血和体重指数（BMI）的影响。
本文系统综述了益生菌补充剂对接受 HAART 和未接受 HAART 的 PLHIV 的 CD4 淋巴细胞计数、病毒载量和贫血的影响的证据。我们检索了医学文献数据库，以确定益生菌补充剂与 HIV 相关结局的随机试验和前后研究，并进行了随机效应荟萃分析。
大多数证据表明，益生菌补充剂仅能适度改善 CD4 淋巴细胞计数，在未接受 HAART 的个体中比在接受 HAART 的个体中影响更大。18 项研究显示，益生菌补充剂使 CD4 淋巴细胞计数增加了 53 个细胞/mm³（95%CI：22 至 85）。然而，益生菌补充剂使血红蛋白浓度降低了 -2.1g/L（95%CI：-4.0 至 -0.2）。虽然益生菌补充剂在接受 HAART 的参与者中对病毒载量没有影响，但在未接受 HAART 的参与者中，病毒载量下降。关于益生菌补充剂对病毒载量影响的研究太少（N=1）。
益生菌补充剂使未接受 HAART 的个体的 CD4 淋巴细胞计数适度增加，但对接受 HAART 的个体没有明显影响。益生菌补充剂后病毒载量和血红蛋白浓度也没有变化。进一步的严格和有力的研究可能会评估益生菌补充剂对接受 HAART 的 PLHIV 重要临床结局的影响。
