Impact of Probiotic Supplementation on Gut Microbiota Recovery After Antibiotic Therapy in HIV-Positive Adults in Makurdi, Benue State

Antibiotic-associated dysbiosis of the gut microbiota is a recognized complication of antibiotic therapy, with particularly significant consequences for immunocompromised individuals including those living with HIV. This study evaluated the impact of probiotic supplementation on gut microbiota recovery markers following antibiotic therapy in HIV-positive adults receiving care at Benue State University Teaching Hospital, Makurdi, North Central Nigeria. A randomized, double-blind, placebo-controlled pilot study was conducted in 60 HIV-positive adults commencing antibiotic treatment for opportunistic infections. Participants were randomized to receive a multi-strain probiotic formulation (Lactobacillus acidophilus, L. rhamnosus, and Bifidobacterium longum) or placebo for four weeks post-antibiotic therapy. Stool samples collected at baseline, end of antibiotic therapy, and four weeks post-antibiotic were analyzed by quantitative PCR for select commensal bacterial groups. Secondary endpoints included diarrhea frequency, CD4 count, and quality-of-life scores. Results showed that probiotic recipients demonstrated significantly faster restoration of Bifidobacterium spp. and Lactobacillus spp. populations and lower diarrhea frequency (23.3% vs. 56.7%) compared to placebo. CD4 count trajectories were similar across groups. These findings suggest clinical benefit of probiotic supplementation for gut microbiota recovery in this population and support further larger-scale trials to define optimal probiotic strains and dosing regimens. Keywords: probiotics, gut microbiota, HIV, antibiotic dysbiosis, Makurdi.