This study aims to evaluate the efficacy, tolerability, and safety of probiotic supplementation as a therapeutic intervention for elders living with HIV who experience symptomatic cognitive impairment. HIV infection induces a pro-inflammatory change in the intestinal microbiome. Gut microbiome alterations and associated consequences, such as dysbiosis, bacterial translocation, and gut-brain axis dysfunction are associated with systemic and central nervous system inflammation that leads to microglial activation and increased production of chemokines and cytokines that contribute to neuronal injury, promoting structural brain alterations, affecting cognitive reserve and performance.
This is a single-center longitudinal interventional pilot involving participants recruited from a tertiary care university-affiliated medical center in Mexico. Participants will undergo baseline cognitive testing, fecal analysis, and determination of serum and cerebrospinal fluid markers of immune activation and inflammation. Participants will be randomized into an intervention (probiotic) and a control group. After a 6-month intervention period, microbiome composition, cognitive testing, and biomarkers will be reassessed and compared in between groups. The intervention in this trial aims to benefit those living and aging with HIV infection, a marginalized population, worldwide. The present study aims to address a current gap in research, and, in doing so, will generate and distribute knowledge to advance the field of brain health and dementia prevention, and ameliorate the burden of cognitive impairment.