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Weighing in on the risks and benefits of probiotic use in HIV-infected and immunocompromised populations

A U Happel1, S L Barnabas1,2, R Froissart3

  • 11 Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Medical School, Anzio Road, Observatory, 7925 Cape Town, South Africa.

Beneficial Microbes
|January 19, 2018
PubMed

Insights

Probiotics show benefits outweighing risks for HIV patients and neonates with colic or necrotising enterocolitis (NEC). Careful use is advised for immunocompromised individuals and the elderly.

Area of Science:

  • Microbiology
  • Immunology
  • Gastroenterology

Background:

  • Probiotics are widely used for various conditions like irritable bowel syndrome, diarrhea, necrotising enterocolitis (NEC), and infant colic.
  • Significant debate exists regarding probiotic efficacy and safety, especially in HIV-infected and immunocompromised populations.

Purpose of the Study:

  • To review safety and adverse event (AE) reporting from clinical trials of probiotics in at-risk populations.
  • To evaluate the risk-benefit profile of probiotics in vulnerable groups.

Main Methods:

  • Systematic review of clinical trial data focusing on safety and AE reporting.
  • Analysis of studies involving HIV-infected individuals, the terminally ill, the elderly, and neonates.

Main Results:

  • Probiotic therapy benefits appear to outweigh risks in HIV-infected populations.
  • Probiotics are beneficial for treating colic and NEC in low birth weight or premature neonates.
  • Severe AEs were predominantly reported in the elderly, terminally ill, or those with severe co-existing medical conditions.

Conclusions:

  • Probiotic use as adjunctive therapy is effective and safe for most patients, including HIV-infected individuals.
  • Caution is warranted for individuals with extreme immunosuppression and severe medical conditions across all age groups.

Keywords:
HIVimmunodeficiencyneonatesprobioticssafety

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