Sa1854 - Oral Bacteriotherapy Improves Gut Inflammation and Reduces Fecal Infectivity of HIV Subjects

INTRODUCTION The gastrointestinal tract is a major site of HIV localization and even though cART (combined AntiRetroviral Therapy) leads to suppression of HIV replication the gastrointestinal pathology is still persistent. In these patients increased levels of inflammation and decreased levels of mucosal repair and regeneration are observed. Consequently novel directions for dietary and therapeutic interventions that restore the immunological and epithelial integrity of the mucosal barrier are needed. Since HIV infected patients host in their gut a prevalence of several detrimental bacterial populations, attempts to modify their gut flora with probiotics is justified. PATIENTS and METHODS Ten subjects receiving combined antiretroviral therapy for HIV-1 were treated for 6 months with multistrain probiotic formulation containing Lactobacillus plantarum DSM24730, Streptococcus thermophilus DSM24731, Bifidobacterium breve DSM24732, L. paracasei DSM24733, L. delbrueckii subsp. bulgaricus DSM24734, L. acidophilus DSM 24735, B. longum DSM24736, B. infantis DSM24737 (Vivomixx in EU, Visbiome in USA). At baseline and 6 months, IELs density and enterocytes death via apoptosis as well as mitochondrial morphology were analyzed by immunoistichemical. Faecal water samples (FWS) were collected at T0 and after 6 month of probiotics treatment and checked for antiviral activity. RESULTS We observed the recovery of the integrity of the gut epithelial barrier by reducing IELs density and enterocytes death via apoptosis as well as mitochondrial morphology. This was associated to an improvement of quality of life. As compared to control, faecal water from patients treated with this specific formulation reduced viral replication in treated cells (C8166 cells, infected with T-cell tropic strain HIV-1 P1 at multiplicities of infection (MOIs) of 0.05 TCID50/ml for 1 hour at 37°C), both at 24h and 48h. The antiviral activity of faecal water from patients treated with probiotics for 6 months (T6 FWS) resulted higher than T0 (38% +/- 10) with a percentage of inhibition of 68% (+/- 24) at 24 hours, further confirmed by the results at 48h where percentage of inhibition of more than 90% was recorded. CONCLUSIONS Our results confirm the gut flora plays a role in the interactions host-HIV also in terms of resistance to the HIV infection and the benefits of this specific probiotic preparation for the amelioration of the intestinal inflammation of cART patients. However, not all the probiotic formulation are equally suited for HIV patients as previously reported therefore our data should not be extrapolated to other untested probiotic products.