Effectiveness of nutritional treatment and synbiotic use on gastrointestinal symptoms reduction in HIV-infected patients: randomized clinical trial
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2017
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Background & aims: Gastrointestinal symptoms are among the most frequent reported complaints by
people living with HIV and AIDS (PLWHA). Treatments that aim to attenuate these symptoms are
important to avoid low adherence to antiretroviral therapy and to improve the quality of life. This study
aimed to evaluate the effectiveness of nutritional treatment and synbiotic use in PLWHA on reducing
gastrointestinal symptoms.
Methods: A randomized clinical trial nested to an outpatient cohort was conducted to evaluate the
effectiveness of two treatments for gastrointestinal symptoms reduction in adult patients with antire troviral therapy presenting at least one gastrointestinal symptom: 1) nutritional treatment þ placebo
(6 g maltodextrin) and 2) nutritional treatment þ synbiotic (Lactobacillus and Bifidobacterium
strains þ 6 g fructooligosaccharides). Placebo and synbiotic were consumed twice a day during six
months. The primary outcome variable was percentage reduction in the incidence of diarrhea, and
secondary outcomes the decrease in the incidence of nausea and/or vomiting, dyspepsia, heartburn,
constipation, flatulence, and the presence of three or more gastrointestinal symptoms.
Results: Out of 283 patients evaluated for eligibility, 64 met inclusion criteria to enter in this study with
1:1 allocation ratio. Both analyzed groups were homogeneous regarding sociodemographic, clinical and
lifestyle variables at baseline. In the intergroup analysis, no difference was found between groups except
for heartburn, which had a higher reduction in the placebo group (0.01). Regarding the intragroup
analysis, in the placebo group a significant decrease in diarrhea (p ¼ 0.02) and heartburn (p < 0.01) were
observed while there was a significant reduction for nausea e/or vomit (p ¼ 0.01), dyspepsia (p ¼ 0.10),
diarrhea (p ¼
Conclusions:
0.01) and constipation (p ¼ 0.08) in the synbiotic group.
Diarrhea decreased in both groups, but no statistical difference between treatments was
observed. The use of synbiotic appeared to reduce a greater number of symptoms although there were no
statistical differences in the intergroup analysis.
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Palavras-chave
HIV, Synbiotic, Gastrointestinal symptoms, ART, Diet therapy
Citação
SANTOS, Annelisa Silva e Alves de Carvalho et al. Effectiveness of nutritional treatment and synbiotic use on gastrointestinal symptoms reduction in HIV-infected patients: randomized clinical trial. Clinical Nutrition, Edinburgh, v. 35, n. 3, p. 680-685, 2017. DOI: 10.1016/j.clnu.2016.06.005. Disponível em: https://www.sciencedirect.com/science/article/pii/S0261561416301352?via%3Dihub. Acesso em: 18 fev. 2025.