Research Team: Rupert Kaul (principal investigator), Mario Ostrowski, Colin Kovacs, Gabe Kandel, Robert Reinhard
What is this research about?
Basic science research conducted by this team has shown that HIV damages the gut reducing the number and function of a key type of immune cell, called Th17 cells. This reduction causes “leaking” of bacteria into the bloodstream and drives immune activation, which has been linked to the increased risk of heart and brain disease in people living with HIV. While antiretroviral therapy can reverse this gut damage, it takes years for gut immune health to recover and in some people it never does.
This study explores the use of a type of complementary therapy, called probiotics, as a potential way to enhance gut immune function and speed improvement in gut health once antiretroviral therapy has begun. Probiotics are supplements use to restore the normal bacteria of the gut.
This research team is undertaking two clinical trials to determine if regular use of probiotic tablets over a one-year trial period can:
- Accelerate the restoration of gut health and immune function in people living with HIV as they start antiretroviral therapy.
- Improve immune function and reducing gut “leakiness” in people living with HIV who have consistently low CD4 counts despite an undetectable viral load on antiretroviral therapy.
In these trials, outcomes for people receiving the probiotic tablets, will be compared to outcomes for people taking a placebo (fake treatment). Participants will have repeat blood and gut samples collected for studies of immune activation and virus levels. Participants initially provided with placebo will be provided with a course of probiotics after the trial if they wish.
OHTN Support: This project is supported by a OHTN 2-year project grant of $305,760 beginning in 2016.