Fetal transplantation corrects immunological problems of the intestinal immune system in HIV

ABC Health

Madrid

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Transplanting intestinal microbiota by capsules in people with HIV improves the composition of intestinal bacteria and an indicator of intestinal permeability, which could have long-term beneficial effects for these people. The results of this research work have been published in the journal Nature Communications.

HIV is a chronic inflammatory disease in which chronic immune dysfunction, which appears to be influenced by the microbiome, leads to persistent inflammation and contributes to an increased risk of mortality. The immune system of mucous membranes is devastated after acute HIV infection. For many years, efforts have been made to reduce these damages in order to control the negative clinical consequences of inflammation in the long term.

‘Today it is widely accepted that gut microbial communities are not passive when faced with HIV infection, but rather play an active role in disease progression, including susceptibility to virus acquisition, efficacy of pre-exposure prophylaxis or chronic inflammation, among others.

Therefore, the aim is to modulate the intestinal microbiota as a strategy to improve clinical results in people living with HIV, ”says Dr. Sergio Serrano, from the Ramón y Cajal University Hospital in Madrid and coordinator of this international multicenter study led by Spanish experts from GeSIDA, AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology.

Multiple studies have evaluated dietary supplementation of various nutritional products, such as prebiotics and probiotics, in people with HIV. However, the two large randomized trials that evaluated the effects of probiotics or symbiotics (a combination of prebiotics and probiotics) on these types of patients who were correctly following their HIV treatment failed to detect differences in any of the outcomes evaluated.

In this work, it was hypothesized that fecal microbiota transplantation would be more effective than previous nutritional interventions aimed at shaping the microbiota in people with HIV and improving inflammation markers. Because an intervention of this type had not been explored before, a controlled pilot study was carried out in which about thirty people with HIV who were correctly following their antiretroviral treatment received eight cycles of fecal microbiota orally or a placebo and subsequently they were followed for 48 weeks.

The main result was that fecal microbiota transplantation using a non-invasive and safe administration strategy is a well-tolerated intervention, is not related to serious adverse events, and attenuates changes in the intestinal microbiota secondary to HIV.

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