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Aims: The gut microbiota exerts a critical influence in the immune system. The gut microbiota of human virus immunodeficiency (HIV)-infected children remains barely explored. We aimed to characterize the fecal microbiota in vertically HIV-infected children and to explore the effects of its modulation with a symbiotic nutritional intervention. Methods: a pilot, double blind, randomized placebo-controlled study including HIV-infected children who were randomized to receive a nutritional supplementation including prebiotics and probiotics or placebo for four weeks. HIV-uninfected siblings were recruited as controls. The V3–V4 region of the 16S rRNA gene was sequenced in fecal samples. Results: 22 HIV-infected children on antiretroviral therapy (ART) and with viral load (VL) <50/mL completed the follow-up period. Mean age was 11.4 ± 3.4 years, eight (32%) were male. Their microbiota showed reduced alpha diversity compared to controls and distinct beta diversity at the genus level (Adonis p = 0.042). Patients showed decreased abundance of commensals Faecalibacterium and an increase in Prevotella, Akkermansia and Escherichia. The nutritional intervention shaped the microbiota towards the control group, without a clear directionality. Conclusions: Vertical HIV infection is characterized by changes in gut microbiota structure, distinct at the compositional level from the findings reported in adults. A short nutritional intervention attenuated bacterial dysbiosis, without clear changes at the community level. Summary: In a group of 24 vertically HIV-infected children, in comparison to 11 uninfected controls, intestinal dysbiosis was observed despite effective ART. Although not fully effective to restore the microbiota, a short intervention with pre/probiotics attenuated bacterial dysbiosis.

Objective: To evaluate the efficacy of modified-release doxazosin 4 mg in the treatment of patients with acute urinary retention (AUR) due to benign prostate gland hyperplasia (BPH). An evaluation is made of the number of patients recovering spontaneous micturition after catheter removal, micturition quality, and the number of patients suffering new AUR episodes or who require surgery in the 2 years following the first episode. Patients and Methods: A randomized, controlled study in males with AUR secondary to BPH. Two groups are formed, administering modified-release doxazosin 4 mg to patients born in even-numbered years, once a day in the morning. Those born in odd-numbered years receive no medication. The catheter is withdrawn 1 month later. Flowmetry is performed, with determination of ultrasonographic postmicturition retention at withdrawal, and after 6, 12 and 24 months. Results: Of the 65 patients included, 47 proved evaluable, and 46 complied with treatment (with exclusion of 1 case due to hypotension). Of the 22 patients treated with doxazosin, 15 (68.86%) presented AUR after 2 years, while 7 (31.2%) showed spontaneous micturition. Of the 24 patients treated with bladder catheterization in the absence of medication, 16 (66.6%) presented AUR after the same period of time, while 8 (33.3%) showed spontaneous micturition. There were no statistically significant differences between the treated and untreated subjects in terms of drug efficacy. Residual flow parameters are described in the population with spontaneous micturition in each stage of the study. Conclusion: In our series, treatment with the α-blocker doxazosin (4 mg, modified-release formulation), added to bladder catheterization, showed no increased efficacy in AUR treatment versus catheterization alone. Two years after the urinary retention episode, 31.2% of the patients treated with modified-release doxazosin 4 mg, and 33.3% of those with a bladder catheter only were seen to maintain spontaneous micturition.

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