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Benef Microbes. 2018 Feb 27;9(2):239-246. doi: 10.3920/BM2017.0106. Epub 2018 Jan 18.

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

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1 Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Medical School, Anzio Road, Observatory, 7925 Cape Town, South Africa.
2 Desmond Tutu HIV Foundation, P.O. Box 13801, Mowbray, 7705 Cape Town, South Africa.
3 Maladies infectieuses et vecteurs: écologie, génétique, évolution et contrôle (MIVEGEC) UMR 5290, CNRS, IRD, Université Montpellier, 911 Avenue Agropolis, 34394 Montpellier, France.
4 CAPRISA DST-NRF Centre of Excellence in HIV Prevention, University of KwaZulu-Natal, King George V Ave, Glenwood, Durban, 4041, South Africa.
5 National Health Laboratory Service, Private Bag X8, Sandringham 2131, Johannesburg, South Africa.


Probiotics are used in the prophylaxis and treatment of several conditions, including irritable bowel syndrome, diarrhoea, necrotising enterocolitis (NEC) and colic in infants. Despite the long history of probiotic use in humans, there is still significant debate about their efficacy and safety, particularly in HIV-infected and immunocompromised individuals. Here, we reviewed the safety and adverse event (AE) reporting from clinical trials that have tested probiotics in at risk populations, including HIV-infected individuals, the terminally ill and elderly, and neonates. Our analysis suggests that the benefits of probiotic therapy outweigh their potential risks in HIV-infected populations, and in the treatment of colic and NEC in low birth weight or premature neonates. Most case reports of severe AEs were in the elderly and terminally ill, or in those with additional severe medical conditions. We conclude that probiotic use, as adjunctive treatment, is effective and safe in the majority of patients including HIV-infected individuals, although special care should be taken in individuals with extreme immunosuppression and severe medical conditions in all ages.


HIV; immunodeficiency; neonates; probiotics; safety

[Indexed for MEDLINE]

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