INTRODUCTION
Immunologic failure, immunologic failure
INTESTINAL INFLAMMATION, RECURRENCE
Antiretroviral therapy (ART) is the basis of treatment for adults with a CD4Viral load and CD4Virologic failure is defined as an incomplete response or no response from HIV RNA to ART or virologic recurrence, as defined below:Incomplete virologic response: more than 200 copies of HIV RNA per milliliter after 24 weeks of treatment with HAART or more than 50 copies/mL at Week 48 of treatment in a patient receiving treatment for the first time.Virologic relapse: HIV RNA up to 400–1000 copies/mL, 4–8 weeks after viral suppression, in two sessions.Immunologic failure: an increase in CD4 cell count of 150/mmGenerally, immunologic failure follows virologic failure, and then clinical exacerbations occur. However, these may occur months to years apart and do not necessarily occur in the order mentioned.In the patients in our study, viral load was minimized and the desired virologic response was achieved, but despite this success, we observed immunologic failure, so according to previous studies we try to increase the gut microflora by probiotics especially with a high count of lactobacilli to reduce intestinal inflammation and achieve an immunologic response.Probiotics are live microorganisms that, when administered in adequate numbers of colonies, can delay immune destruction and help maintain immunity in HIV patients. A study by Ruben Hummeln et al. investigated the effect of probiotics on the immune system of patients with HIV. The results indicate that at the end of Week 25, the group that received a placebo in combination with ART had an increase of mean of 19 CD4 cells/μL and the group that received probiotics in combination with ART had an increase of mean of 46 CD4 cells/μL.Several other studies have shown the effect of probiotics on increasing CD4 cell counts. Based on these results, we designed this study to investigate the effect of probiotics in patients who have immunologic failure despite virologic success.