The clinical relevance of the microbiome when managing paediatric infectious diseases—Narrative review

Sainz, Talía; Delgado, J. A. De B. A.; Méndez-Echevarría, Ana; Santiago, Begoña; López-Varela, Elisa; Aguilera‐Alonso, David; Saavedra-Lozano, Jesús; Rodríguez‐Fernández, Rosa; Holguín, África; Navarro, Marisa; Muñoz‐Fernández, María Ángeles; Rivero‐Calle, Irene; Solana, María José; López‐Herce, Jesús; Calvo, Cristina

doi:10.1111/apa.15578

Cited by 1 publication

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References 58 publications

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“…However, the microbiome seems to be quite stable once established [31][32][33], and therefore, childhood may be an interesting window in which to intervene. The first years of life represent a critical developmental window both for the establishment of the microbiome and immune system development [34][35][36]. Unfortunately, very few interventional studies with the working hypothesis that alterations in the microbial landscape may contribute to the chronic inflammation/immune dysregulation associated to HIV, have included children.…”

Section: Microbiome As a Treatment Target In Childrenmentioning

confidence: 99%

Pediatric perspective: the microbiome in vertical HIV-infection: unravelling gaps, challenges, and therapeutic potential

Sainz,

Aldrovandi

2024

Current Opinion in HIV and AIDS

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Purpose of review The intricate interplay between HIV and the host microbiota has emerged as a significant area of investigation with therapeutic potential. Despite numerous studies on this complex interaction in adults, vertically acquired infections, which have distinct immunological and virological characteristics, remain relatively understudied. Recent findings Disturbances, including prolonged exposure to HIV and antiretroviral therapy, significantly impact the gut microbiome, though isolating these effects from other influencing factors is challenging. Children and adolescents living with HIV exhibit reduced microbiome diversity and potential imbalances between beneficial and pathogenic taxa. However, most available data focus on microbiome composition rather than function. The observed variations in specific microbial phyla are intriguing, but their health effects are unknown. Although modulating the microbiota may be theoretically easier during childhood, few interventional trials have included children. Summary Therapeutic interventions aimed at modulating the gut microbiome in children with HIV have shown limited impact, and their ability to induce long-term microbiome changes remains uncertain. A more functional, longitudinal approach, along with an ecological perspective, is needed to understand the complex interplay between the microbiome and the host. This will help clarify the relevance of microbiota alterations and their potential implications for clinical outcomes, such as inflammation and immune reconstitution in pediatric HIV.

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