Immune activation and gut microbiota can be positively modified in HAART-naïve HIV-infected adults by specific prebiotics

Objective: The intestinal mucosal immune system is an early target for HIV-1 infection, resulting in profound CD4+ T-cell depletion, deterioration of gut lining and disturbance of fecal microbiota composition; changes suggested to influence disease progression. We evaluated microbiota and immune effects of a prebiotic oligosaccharide mixture (i.e. non-digestible food ingredients that modify intestinal microbiota balance) in HAART-naïve HIV-1-infected adults. Design and methods: In a double-blind, randomized, placebo-controlled study (COPA-trial), 57 HAART-naïve HIV-1 infected adults received either a unique oligosaccharide mixture (15g or 30g scGOS/lcFOS/pAOS daily) or a control product for 12 weeks. Fecal microbiota composition and immune function were evaluated. Results: Microbiota composition improved significantly with increased Bifidobacteria levels and decreased Clostridium coccoides/Eubacterium rectale cluster and decreased pathogenic Clostridium lituseburense/ Clostridium histolyticum group levels upon prebiotic supplementation. In addition a dose-dependent reduction of activated CD4+/CD25+T-cells was seen and significantly increased NK-cell activity in the 30g/d dose group at E/T-ratio of 12.5:1 and in the 15g/d group at all E/T-ratios tested (12.5:1, 25:1, 50:1) as compared to control group. Conclusions: Short term dietary supplementation with this unique oligosaccharide mixture results in improvement of gut microbiota composition, reduction of immune activation and improved NK cell activity in HAART-naïve HIV-infected individuals.