This is a single arm study all subjects will receive the study VSL#3 probiotic. Subjects will take 1 sachet of powder orally daily for 12 weeks

Other: VSL#3® probiotic VSL#3® DS (Sigma-Tau Pharmaceuticals) is a well characterized water soluble, live (9 × 1011 bacteria/sachet), lyophilized preparation of 8 probiotic bacterium that have been detailed previously. Subjects will take 1 sachet of powder orally daily for 12 weeks. As many Malian homes lack refrigeration, subjects will be issued a special "canari", a commonly used earthenware water container also containing sand that works on the principal of "trans-evaporation" to keep contents at room temperature (~24°C) even in warmer climates. We have verified this in country. Probiotics will be placed in a sealed plastic bag within a sealed jar in the sand of the canari. At the research site, probiotics will be kept refrigerated (4-8°C) in a study provided refrigerator

VSL#3® probiotic

Nianankoro Fomba Hospital

Pilot Study of Oral Probiotic Bacteria Supplementation to Reduce Chronic Immune Activation in HIV-infected Malian Women

A Pilot Study of Oral Probiotic Bacteria Supplementation to Reduce Microbial Translocation and Chronic Immune Activation in HIV-infected Malian Women

sCD14 is marker of monocyte response to endotoxin associated with mortality

sCD163 is a marker of monocyte activation associated with cardiovascular disease (CVD)

IL-6 is associated with mortality and CVD

d-dimer is associated with mortality and CVD

intestinal fatty acid biding protein is associated with gut epithelial cell injury

CD4 is associated with HIV disease progression

fecal calprotectin is associated with gut inflammation

Virginia Commonwealth University

Bill and Melinda Gates Foundation

Crohn Disease

Only patients undergoing endoscopy for clinical reasons will be included in the study, i.e. no endoscopies will be performed solely for study reasons. For the purposes of our study, endoscopy serves to determine the degree of inflammation and no additional biopsies are taken. Blood for CRP and ficolin-2 analysis will be taken through the Venflon® installed for endoscopy.

colitis/protease

Pilot Study of Oral Probiotic Bacteria Supplementation to Reduce Chronic Immune Activation in HIV-infected Malian Women

Significance of Ficolin 2 in the Determination of Serological Activity in Chronic Inflammatory Bowel Disease

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