Meds, Mind, Body & Benefits > Nutrition & HIV

Probiotics-Perhaps a way to increase CD4 counts?

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Hi all. New here to the community. Have been following all your great advice ‘as a guest’ since learning of my HIV status in Dec 2010. Feel comfortable now to contribute and therefore have just registered here to actively contribute.

To begin, I just want to thank you to all of you who actively participate in these forums including the moderators. I have learnt so much from you all and now feel more at ease with my HIV status and future. I am sure there are many more who visit this forum who have also greatly benefited from your knowledgeable (and some not so knowledgeable) contributions  ;) You are fantastic and your advice is truly comforting. Knowledge is power.

Just a quick intro about me… a 44 years Caucasian male now living in a progressive (ie economic only!!!!) and prosperous South East Asian island state, I must be discreet about my HIV status. If discovered by the health authorities, one is immediately deported.

Doctors here are frequently known to routinely test for HIV when patients are presenting for other health conditions. This HIV testing is not advised to the patient and consent is not needed….a truly scary situation that is hard to believe exists here in the 21 century…..I now know what it is like to be persecuted!!!

Therefore I have been advised ‘by those in the know’ to fly to neighbouring Thailand for all my meds and specialist consultations. I have been doing this since learning of my HIV status in late 2010 and have no choice but to run the ‘customs/immigration gauntlet’ upon returning with my newly stock of meds packed in my suit case.

So far so good however with no bag searches conducted upon entry……fingers and toes are always crossed!! Feel that my beads of sweat are going to give me away one of these days just like in one of those hollywood movies ;-) I understand from my Thai specialist that there is a considerable contingent of foreigners working/living here that unfortunately have to do the same.

Thankfully my jaunt to Thailand is now only needed twice per year. I started treatment immediately and am fortunate that my CD4 counts have plateaued at around 700 (49%) and viral load successfully suppressed since early 2011 due to my Kivexa and Stocrin combo.  :)

I have stumbled upon this article on the net (copied below), and was wondering what others thought about it….could this be potentially a simple way of improving immunity and CD4 counts? I understand that probiotics are not all considered equal and therefore simply by eating yoghurt from the supermarket to increase CD4 counts may not assist.

Perhaps by consuming this harmless branded probiotic (in gell form) and therefore avoiding the stomach acid may be a way of populating CD4 cells in the gut for CD4 count restoration and expansion therefore improving counts CD4 counts overall?

I found it very interesting to read elsewhere that over 70% of CD4 cells are located in the gut and that HIV enjoys hiding out in the gut-associated lymphoid tissue (GALT) as reservoirs even with patients successfully supressing the virus. So the gut is quite significant in all of this.

Has anyone here trialled this probiotic product, perhaps regularly consuming it after their CD4 counts had plateaued, and thus can point to some encouraging results? Thanks for your feedback.

CROI 2012 Oral Presentation #95. Probiotic Supplementation of ARV Treatment during SIV Infection of Pigtail Macaques Results in Enhanced GI Tract CD4+ T Cell Frequency and Immunological Function

During progressive HIV/SIV (simian immune deficiency virus in monkeys) infections, damage to the GI tract leads to microbial translocation, which may contribute to chronic immune activation and disease progression.

This study treated chronically SIV-infected pigtail macaques monkeys (PTM) with probiotics (brand name: Culturelle) in combination with ARV treatment, and compared to chronically SIV-infected PTM treated with ARV alone. Combination ARV therapy included 30mg/kg PMPA (a nucleoside that has been extensively used in SIV studies), 30mg/kg emtricitabine (FTC) (once daily, s.c.), and 120mg L812, 50mg L564 (twice daily, oral integrase inhibitors) for an average of 162 days.

The study team found that, compared to PTM treated with ARV alone, animals given probiotics and ARV had enhanced reconstitution of CD4+ T cells in the colon (almost double the CD4 cell counts attained by the ARV alone group). Furthermore, probiotic treatment decreased the activation of CD4+ T cells in the colon and increased the overall functionality of colon CD4+ T cells as measured by multifunctional cytokine production, with indications of enhanced mucosal immunity.

Although this was a monkey study, the presenter hinted at the possibility of expecting similar results in humans infected with HIV. Since probiotics do not colonize the GI track, they need to be dosed daily or frequently, however.

In my situation, I'm reaching for probiotics because of inconsistent digestive problems brought about by IBS, maybe the medications and diarrhea/constipation issues.  I doubt I would have reached for probiotics when my Tcells had peaked or when I knew I was healthy. 

That said, in the United States, many efforts are made to make healthy eating - such as adding probiotics directly to yogurt.  There are only a few products out on the market that actually implies that their product (whole or partially) survives the stomach acids and allows for colonization in the large and small intestine.  One over the counter product available through Amazon or other places is Sustenex.  It claims to use BC30 - which is supposedly the only probiotic known to successfully go past the stomach.   

I'm just starting taking it, so I won't know for a while if it actually works for me to help with my digestive problems and we'll see how or if it impacts blood work in a few months.

There was a very interesting article in June's edition of Scientific American discussing the bacteria that live in and on our bodies. There is only a short preview available online, but if you can manage to get a hold of a hard-copy, I'd highly recommend reading the whole article.

In Brief:

    Bacterial cells in the body outnumber human cells by a factor of 10 to 1. Yet only recently have researchers begun to elucidate the beneficial roles these microbes play in fostering health.

    Some of these bacteria possess genes that encode for beneficial compounds that the body cannot make on its own. Other bacteria seem to train the body not to overreact to outside threats.

    Advances in computing and gene sequencing are allowing investigators to create a detailed catalogue of all the bacterial genes that make up this so-called microbiome.

    Unfortunately, the inadvertent destruction of beneficial microbes by the use of antibiotics, among other things,  may be leading to an increase in autoimmune disorders and obesity. source

In the article, there is a detailed discussion about regulatory T-cells and pro-inflammatory T-cells (see this lesson). A small excerpt (not available online) of this discussion follows:

For years researchers assumed that this system of checks and balances (regulatory and pro-inflammatory T-cells) was generated entirely by the immune system. But in yet another example of how little we control our own fate, Mazmanian and others are starting to show that a healthy, mature immune system depends on the constant intervention of beneficial bacteria. "It goes against dogma to think that bacteria would make our immune systems function better," he says. "But the picture is getting very clear: the driving force behind the features of the immune system are commensals*."

*commensal [kəmen′səl]
Etymology: L, com, together, imensa, table

(two different species) living together in an arrangement that is not harmful to either and that may be beneficial to both. Some bacteria in the digestive tract of humans aid in the processing of food and produce B vitamins needed for normal health while causing no harm (normal flora). source

It's a very good article - lots of food for thought, if you'll pardon the pun. If there's anyone who cannot get a hard-copy of the magazine, I'm willing to either make copies and send it via post, or have it scanned so it can be sent via email. Send me a PM if you're interested. :)

PS - there is another interesting article in June's edition of Scientific American that people here might want to read, but again, it's only available online as a preview. HIV Researcher Probes Vulnerabilities in the Virus for Clues to a Vaccine. It's an interview with a young hiv researcher called Thumbi Ndung'u.

Do you take probiotic, Ann? Just curious... I do... And I have wondered if that has any sort of play with why my numbers are what they are... I'd say most is probably genetics mixed in with diet, etc... I take some other supplements too... But have always been curious about probiotics because, yes, most of your immune system is in your gut so it makes sense (to me) to do everything possible for a healthy gut to help out your body. I'm interested in this sort of thing. :)


--- Quote from: forrest on July 14, 2012, 01:23:44 PM ---
Do you take probiotic, Ann?

--- End quote ---

Usually only while I'm on an antibiotic and a week or so after. I might re-think that (and use more) after further investigation.


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