Probiotics Reduce Necrotizing Enterocolitis Severity in HIV-exposed Premature Infants

J Trop Pediatr. 2015 Jun;61(3):155-64. doi: 10.1093/tropej/fmv004. Epub 2015 Feb 26.


Objective: To assess the effect of probiotics on the incidence of necrotizing enterocolitis (NEC) in premature infants born to human immunodeficiency virus (HIV)-positive and HIV-negative women.

Patients and methods: HIV-exposed and HIV-unexposed premature infants were randomized to either the probiotic or the placebo group. The probiotic consisted of 1 × 10(9) colony-forming units, Lactobacillus rhamnosus GG and Bifidobacterium infantis per day.

Results: In total, 74 HIV-exposed and 110 HIV-unexposed infants were enrolled and randomized. The incidence of death [4 (5.4%) vs. 7 (6%); p = 0.79] and NEC [4 (5%) vs. 5 (5%); p = 0.76] did not differ significantly between the HIV-exposed and HIV-unexposed groups. A significant difference was found for total NEC incidence between the study and control groups [3 (3%) vs. 6 (6%); p = 0.029]. The incidence of NEC in the HIV-exposed group differed significantly [Bells I 2 (5%) vs. Bells III 2 (5%); p = 0.045).

Conclusion: Probiotic supplementation reduced the incidence of NEC in the premature very low birth weight infants; however, results failed to show a lower incidence of NEC in HIV-exposed premature infants. A reduction in the severity of disease was found in the HIV-exposed study group.

Keywords: human immunodeficiency virus; necrotizing enterocolitis; premature infant; probiotic; very low birth weight.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bifidobacterium*
  • Dietary Supplements*
  • Double-Blind Method
  • Enterocolitis, Necrotizing / epidemiology
  • Female
  • HIV Infections*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight
  • Lactobacillus rhamnosus*
  • Probiotics / therapeutic use*
  • Severity of Illness Index