Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 to prevent or cure bacterial vaginosis among women with HIV

Hummelen, Ruben; Changalucha, John; Butamanya, Nicodemus L.; Cook, Adrian; Habbema, J. Dik F.; Reid, Gregor

doi:10.1016/j.ijgo.2010.07.008

« Previous Next »International Journal of Gynecology & Obstetrics
Volume 111, Issue 3 , Pages 245-248, December 2010

Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 to prevent or cure bacterial vaginosis among women with HIV

Ruben Hummelen
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, The Netherlands
- Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Canada
- Corresponding author. Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, 268 Grosvenor St., London, Ontario, Canada N6A 4V2. Tel.: +1 519 646 6100x64012; fax: +1 519 646 6031.
John Changalucha
- National Institute for Medical Research, Mwanza Research Centre, Tanzania
Nicodemus L. Butamanya
- Sekou-Toure Regional Hospital, Mwanza, Tanzania
Adrian Cook
- Kivulini Womens’ Rights Organisation, Mwanza, Tanzania
J. Dik F. Habbema
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, The Netherlands
Gregor Reid
- Departments of Microbiology, Immunology and Surgery, The University of Western Ontario, London, Canada
- Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute, London, Canada

Received 9 April 2010; received in revised form 30 June 2010; accepted 28 July 2010. published online 01 September 2010.

Abstract

Objective

To assess, among women with HIV, whether long-term oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 supplementation can prevent bacterial vaginosis (BV) and enhance the cure rate of metronidazole among those with BV.

Methods

A randomized, double-blind, placebo-controlled trial conducted among 65 HIV-infected women with an aberrant microbiota (Nugent score 4–10) who were randomized to receive daily probiotics or placebo for 6months. Those with BV (Nugent score 7–10) additionally received metronidazole for 10days (400mg twice daily).

Results

We did not find an enhanced cure rate of BV among women with HIV treated with adjuvant probiotics to metronidazole treatment. Among women with an intermediate vaginal flora, probiotics tended to increase the probability of a normal vaginal flora (odds ratio 2.4; P=0.1) and significantly increased the probability of a beneficial vaginal pH (odds ratio 3.8; P=0.02) at follow-up.

Conclusion

Supplementation of probiotic L. rhamnosus GR-1 and L. reuteri RC-14 did not enhance the cure of BV among women living with HIV, but may prevent the condition among this population. Trial registration: NCT00536848.

Keywords: Bacterial vaginosis, HIV, Metronidazole, Probiotics, Supplementation