in the blood of HIV patients.
The good news: HIV medications reduce the amount of inflammation as they control the virus. The bad news is the amount of inflammation is still higher than normal, even with effective HIV treatment. This inflammation in HIV is a problem because it can cause damage in the blood vessels and increase the risk of cardiovascular disease.
The other problem in the gut is that HIV disease causes a change in the composition of bacteria living in the gut. HIV infection alters the gut microbiome. The good bacteria that are normally in the gut are slowly replaced by bacteria that are not so good. Keeping these good bacteria in the gut is very important because they help us digest food and absorb nutrients and even are needed to produce certain vitamins that we use.
Is there any way we can target the gut microbiome and improve health outcomes for HIV infection? There are two ways that we may be able to do this. Prebiotics are foods or supplements we consume take that can nourish and increase levels of good bacteria. These foods and products contain dietary fiber that undergoes a special process in the large intestine (fermentation) that nourishes the growth of good bacteria.
Probiotics are the actual good bacteria themselves. They can be acquired from eating fermented foods, such a yogurt with live cultures or sauerkraut. They contain important good bacteria like Lactobacillus (sound familiar?) and Bifobacterium. There are also tablet supplements that contain these bacteria. So the big question is: Do they work? In a number of studies, eating yogurt enriched with probiotic bacteria has led to some mild increases in CD4+ lymphocytes in HIV patients on treatment. In other studies, probiotic supplements have produced a number of benefits which include reduced inflammation, possible reductions in bacteria leaking from the gut and normalization of the gut microbiome.