补充益生菌对成年HIV感染者CD4+T细胞计数和炎症的影响：一项系统综述和荟萃分析

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine Pub Date : 2025-04-04 DOI:10.1016/j.eujim.2025.102453

Min Wen , Guoyan Yang , Lipan Yang , Yan Yuan , Dennis Chang

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引用次数: 0

摘要

本系统综述和荟萃分析旨在评估益生元和合成益生菌补充对人类免疫缺陷病毒（HIV）感染成人的分化4阳性T细胞（CD4+ T细胞）计数和生物标志物的影响。方法本系统综述检索PubMed、Cochrane Library、Embase、PubMed数据库、中文电子数据库（中国知网、维普网、万方网）、世界卫生组织（WHO）国际临床试验注册平台（ICTRP）和Clinical Trials.gov试验注册库。采用Cochrane偏倚风险评估工具2.0进行偏倚风险评估，meta分析采用RevMan 5.1软件。根据接受抗逆转录病毒治疗（ART）或未接受ART治疗的参与者、来自低收入或中等收入国家或高收入国家以及干预持续时间进行亚组分析。结果纳入15项随机对照试验（RCTs），共纳入733例hiv感染者。大多数纳入的试验的方法学质量为中等。补充益生菌没有显著增加hiv感染者的CD4+ T细胞(MD: 37.74, 95% CI:13.75 ~ 87.04；I2 = 71%；10的研究;P = 0.15)。亚组分析还显示，在益生菌组中，CD4+ T细胞计数没有显著增加。本荟萃分析中没有纳入评估可溶性炎症标志物的试验。9项研究报告了不良事件，益生菌组和安慰剂组之间无统计学差异(OR: 1.58, 95% CI: 0.75至3.32；9项研究，I2= 51%, P = 0.22)。结论本荟萃分析的结果表明，补充益生菌可能对CD4+ T细胞计数没有影响。报告的不良事件似乎与益生菌治疗无关。系统评论RegistrationPROSPERO （ID: CRD42020159975）

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Effect of probiotics supplementation on CD4+T cell counts and inflammation in adults living with HIV: A systematic review and meta-analysis

Introduction

This systematic review and meta-analysis aimed to evaluate the effect of prebiotics and synbiotics supplementation on cluster of differentiation 4 positive T cell (CD4⁺ T cell) counts and biomarkers of inflammation adults living with Human Immunodeficiency Virus (HIV).

Methods

The present systematic review searched in PubMed, Cochrane Library, Embase, PubMed databases, and Chinese electronic databases (CNKI, VIP, Wanfang), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and the Clinical Trials.gov trials registers. The Cochrane risk of bias assessment tool 2.0 was employed to assess the risk of bias, and meta-analyses used RevMan 5.1 software. Subgroup analysis was performed according to participants who accepted Antiretroviral Therapy (ART) or were ART naive, from low- or middle-income countries or high-income countries and by duration of intervention.

Results

Fifteen Randomized Controlled Trials (RCTs) including 733 HIV-infected individuals were included in this review. The methodological quality of most included trials was moderate. Probiotics supplementation showed no significant increase in CD4⁺ T cells in HIV-infected individuals (MD: 37.74, 95 % CI:13.75 to 87.04; I² = 71 %; 10 studies; P = 0.15) compared with placebo. Subgroup analyses also showed that CD4⁺ T cell counts did not increase significantly in the probiotics group. No trial assessing soluble inflammatory markers was included in this meta-analysis. Adverse events were reported in nine studies and there was no statistically significant difference between the probiotics and placebo groups (OR: 1.58, 95 %CI: 0.75 to 3.32; 9 studies, I²= 51 %, P = 0.22).

Conclusion

The results of this meta-analysis suggested that probiotics supplementation may have no effect on CD4⁺ T cells counts. The adverse events reported appeared to have no correlation with the probiotics treatments.

Systematic Review Registration

PROSPERO (ID: CRD42020159975)

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来源期刊

European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

4.70

自引率

4.00%

发文量

102

审稿时长

33 days

期刊介绍： The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.