Sergio Serrano-Villar, Alba Talavera-Rodríguez, María José Gosalbes, Nadia Madrid, José A. Pérez-Molina… & Santiago Moreno. Fecal microbiota transplantation in HIV: A pilot placebo-controlled study

Nat Commun. 2021

“Our results indicate that the gut microbiota is a feasible therapeutic target to ameliorate chronic inflammation in HIV infection”. – Dr. Sergio Serrano Villar -.


Changes in the microbiota have been linked to persistent inflammation during treated HIV infection. In this pilot double-blind study, we study 30 HIV-infected subjects on antiretroviral therapy (ART) with a CD4/CD8 ratio < 1 randomized to either weekly fecal microbiota capsules or placebo for 8 weeks. Stool donors were rationally selected based on their microbiota signatures. We report that fecal microbiota transplantation (FMT) is safe, not related to severe adverse events, and attenuates HIV-associated dysbiosis. FMT elicits changes in gut microbiota structure, including significant increases in alpha diversity, and a mild and transient engraftment of donor's microbiota during the treatment period. The greater engraftment seems to be achieved by recent antibiotic use before FMT. The Lachnospiraceae and Ruminococcaceae families, which are typically depleted in people with HIV, are the taxa more robustly engrafted across time-points. In exploratory analyses, we describe a significant amelioration in the FMT group in intestinal fatty acid-binding protein (IFABP), a biomarker of intestinal damage that independently predicts mortality. Gut microbiota manipulation using a non-invasive and safe strategy of FMT delivery is feasible and deserves further investigation. Trial number: NCT03008941.

Why do you highlight this publication?

In contrast with previous interventions, we found that it is possible to induce long-lasting changes on the gut microbiota in HIV through an intervention targeting the gut microbial ecology, which resulted in amelioration of an immunological predictor of mortality. The results encourages further research in this field.

Dr. Sergio Serrano Villar

Infectious Diseases Service and HIV / AIDS Unit
Ramón y Cajal University Hospital


Graphic summary
Almetrics, 26th of February 2021

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