{"title":"人类免疫缺陷病毒感染人群的粪便微生物群移植:系统回顾与元分析》。","authors":"Adnan Malik, Muhammad Imran Malik","doi":"10.14740/gr1624","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with human immunodeficiency virus (HIV) infection suffer from alterations in gut microbiota due to recurrent gastrointestinal infections and systemic inflammation. Fecal microbiota transplantation (FMT) appears to be a potential therapy; however, there are concerns about its safety. Likewise, no previous meta-analysis evaluated FMT efficacy in HIV-infected patients.</p><p><strong>Methods: </strong>We conducted a thorough electronic search on PubMed, Scopus, OVID, Web of Science, and Cochrane CENTRAL for clinical studies assessing the safety and efficacy of FMT in patients with HIV and gastrointestinal dysbiosis, where FMT was indicated to restore the disrupted microbiota.</p><p><strong>Results: </strong>FMT significantly restored the typical microbiome in patients with <i>Clostridium difficile</i> (<i>C. difficile</i>) and non-<i>C. difficile</i> and reduced the risk of gastrointestinal infections in HIV patients receiving antiretroviral therapy (odds ratio (OR) = 0.774, 95% confidence interval (CI): (0.62, 0.966)). Furthermore, adverse events, such as distention and bloating, associated with FMT were comparable between HIV and health controls (OR = 0.60, 95% CI: (0.07, 4.6)), with no statistical difference.</p><p><strong>Conclusions: </strong>Current evidence demonstrated that FMT is safe and effective in HIV patients suffering from alterations in gut microbiota. We recommend further multi-centric clinical studies to address the optimal transplant amount and source for FMT. To the best of our knowledge, this is the first meta-analysis to assess the safety and efficacy of FMT in patients with HIV.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/f4/gr-16-209.PMC10482600.pdf","citationCount":"0","resultStr":"{\"title\":\"Fecal Microbiota Transplantation in Human Immunodeficiency Virus-Infected Patient Population: A Systematic Review and Meta-Analysis.\",\"authors\":\"Adnan Malik, Muhammad Imran Malik\",\"doi\":\"10.14740/gr1624\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patients with human immunodeficiency virus (HIV) infection suffer from alterations in gut microbiota due to recurrent gastrointestinal infections and systemic inflammation. Fecal microbiota transplantation (FMT) appears to be a potential therapy; however, there are concerns about its safety. Likewise, no previous meta-analysis evaluated FMT efficacy in HIV-infected patients.</p><p><strong>Methods: </strong>We conducted a thorough electronic search on PubMed, Scopus, OVID, Web of Science, and Cochrane CENTRAL for clinical studies assessing the safety and efficacy of FMT in patients with HIV and gastrointestinal dysbiosis, where FMT was indicated to restore the disrupted microbiota.</p><p><strong>Results: </strong>FMT significantly restored the typical microbiome in patients with <i>Clostridium difficile</i> (<i>C. difficile</i>) and non-<i>C. difficile</i> and reduced the risk of gastrointestinal infections in HIV patients receiving antiretroviral therapy (odds ratio (OR) = 0.774, 95% confidence interval (CI): (0.62, 0.966)). Furthermore, adverse events, such as distention and bloating, associated with FMT were comparable between HIV and health controls (OR = 0.60, 95% CI: (0.07, 4.6)), with no statistical difference.</p><p><strong>Conclusions: </strong>Current evidence demonstrated that FMT is safe and effective in HIV patients suffering from alterations in gut microbiota. We recommend further multi-centric clinical studies to address the optimal transplant amount and source for FMT. To the best of our knowledge, this is the first meta-analysis to assess the safety and efficacy of FMT in patients with HIV.</p>\",\"PeriodicalId\":12461,\"journal\":{\"name\":\"Gastroenterology Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/f4/gr-16-209.PMC10482600.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastroenterology Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14740/gr1624\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastroenterology Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14740/gr1624","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/26 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:人类免疫缺陷病毒(HIV)感染患者因反复胃肠道感染和全身炎症而导致肠道微生物群改变。粪便微生物群移植(FMT)似乎是一种潜在的疗法,但其安全性令人担忧。同样,以前也没有荟萃分析评估过粪便微生物群移植在艾滋病病毒感染者中的疗效:我们在 PubMed、Scopus、OVID、Web of Science 和 Cochrane CENTRAL 上进行了一次全面的电子检索,以评估 FMT 在 HIV 感染者和胃肠道菌群失调患者中的安全性和有效性:结果:FMT 能明显恢复艰难梭菌(C. difficile)和非艰难梭菌患者的典型微生物群,降低接受抗逆转录病毒治疗的艾滋病患者的胃肠道感染风险(几率比(OR)= 0.774,95% 置信区间(CI):(0.62, 0.966))。此外,与 FMT 相关的不良事件,如腹胀和腹胀,在 HIV 感染者和健康对照组之间具有可比性(OR = 0.60,95% 置信区间:(0.07,4.6)),无统计学差异:目前的证据表明,FMT 对肠道微生物群发生变化的 HIV 患者是安全有效的。我们建议进一步开展多中心临床研究,以确定 FMT 的最佳移植量和来源。据我们所知,这是第一项评估 FMT 在艾滋病患者中的安全性和有效性的荟萃分析。
Fecal Microbiota Transplantation in Human Immunodeficiency Virus-Infected Patient Population: A Systematic Review and Meta-Analysis.
Background: Patients with human immunodeficiency virus (HIV) infection suffer from alterations in gut microbiota due to recurrent gastrointestinal infections and systemic inflammation. Fecal microbiota transplantation (FMT) appears to be a potential therapy; however, there are concerns about its safety. Likewise, no previous meta-analysis evaluated FMT efficacy in HIV-infected patients.
Methods: We conducted a thorough electronic search on PubMed, Scopus, OVID, Web of Science, and Cochrane CENTRAL for clinical studies assessing the safety and efficacy of FMT in patients with HIV and gastrointestinal dysbiosis, where FMT was indicated to restore the disrupted microbiota.
Results: FMT significantly restored the typical microbiome in patients with Clostridium difficile (C. difficile) and non-C. difficile and reduced the risk of gastrointestinal infections in HIV patients receiving antiretroviral therapy (odds ratio (OR) = 0.774, 95% confidence interval (CI): (0.62, 0.966)). Furthermore, adverse events, such as distention and bloating, associated with FMT were comparable between HIV and health controls (OR = 0.60, 95% CI: (0.07, 4.6)), with no statistical difference.
Conclusions: Current evidence demonstrated that FMT is safe and effective in HIV patients suffering from alterations in gut microbiota. We recommend further multi-centric clinical studies to address the optimal transplant amount and source for FMT. To the best of our knowledge, this is the first meta-analysis to assess the safety and efficacy of FMT in patients with HIV.