Ann-Margaret Navarra

Abstract

Current evidence supports the concept that oral administration of probiotic lactobacilli may be therapeutic in preventing antibiotic-associated diarrhea in children and in reestablishing normal flora in the gastrointestinal tract. Children with human immunodeficiency virus (HIV) infections may have episodes of diarrhea and frequently experience malabsorption associated with possible bacterial overgrowth; together these may interact to produce the growth abnormalities characteristic of this group. The overall objective of this investigation has been to determine whether oral administration of the probiotic Lactobacillus plantarum 299v could improve nutrient status and promote growth in children congenitally exposed to HIV. In addition, the possible beneficial effect of Lactobacillus plantarum 299v in modulating immune response was evaluated. In preliminary results described here, we report on the ability of Lactobacillus plantarum 299v to colonize children with HIV and to elicit specific systemic immune response after oral supplementation.

Abstract

Recent availability of VL monitoring and multiple ARVT have ushered in a new era of medical management in patients (pts) with HIV. Studies in adults have demonstrated dramatic reductions in VL following the use of newer ARVT. We analyzed our first experiences in utilizing VL monitoring in a pediatric clinical setting, to examine the effect of changing ARVT on VL in children. VL was measured by the Roche-Amplicor PCR HIV Monitor Test. Of pts 1-13 yrs who had at least one VL between 7/96 - 12/96, 6 pts had a change in ARVT 4 weeks prior to the first VL (C), 23 pts had change 4-12 weeks prior to VL (B), and 35 had ARVT change >12 weeks prior to VL (A). Mean ± SD VL (copies/ml) and CD4 index (CD4 count/ 50% for age) were compared between these 3 groups. Viral Load CD4 Index p values (for VL) A 180,760±229,530 .42±37 A v B:

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