A recent article, technical as usual, looked at the kinds of bacteria found in the intestines of people living with HIV vs those uninfected (and included one long-term non-progressor who has lived 21 years without treatment and no progression). What they found was described beautifully in this post with embedded video.
The idea presented was that perhaps we can help reduce bodywide inflammation by establishing a more healthy bacterial profile in the gut. An idea we have been talking about for decades!! And indeed, this is why we have proposed the use of agents like glutamine (which help the cells lining the gut called villi to turnover), along with probiotics and prebiotics (fiber and/or beta glucans). These are rather blunt tools but do seem to help improve gut function. We do have some data on the use of probiotics in the management of HIV-related diarrhea and for bacterial vaginosis (and our sister organization, FIAR, is working on a meta-analysis on those data). While these kinds of interventions have some benefit, ultimately, understanding what one’s ideal “microbiome fingerprint” is — what is the balance of different types of bacteria that colonize your gut under uninfected conditions — and figuring out how to replace that may provide a substantial improvement in clinical condition, dramatically reducing bodywide inflammation that may persist even under conditions of antiviral suppression.
See the NYBC website for more information on PROBIOTICS