Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, PhD, PA-C


Objective: The objective of this selective EBM review is to determine whether or not probiotics are safe and effective in reducing the incidence of diarrhea in HIV-positive individuals.

Study Design: Systematic review of three English language primary studies, published in 1998, 2007, and 2008.

Data Sources: Three double-blind, randomized, controlled trials published after 1996, comparing administration of probiotics with placebo, were obtained using EBSCOhost, PubMed, and Cochrane databases.

Outcomes Measured: Frequency and consistency of stools. Daily or weekly questionnaires allowed subjects to report perceived severity of symptoms using scales containing descriptive words and figures with corresponding numeric values. Subjects were evaluated initially at baseline and subsequently at the completion of the studies, and the results were compared.

Results: No intervention-related negative side effects or adverse events were reported in any of the studies. Anukam and colleagues found that those women treated with probiotics had rapid resolution of diarrhea compared to controls, for both the duration of treatment at day fifteen and at follow-up on day ninety. Trois, et al. reports a decrease in loose stools and an increase in normal stools in both groups but no statistically significant decrease in diarrhea in the probiotic group as compared with control.

Conclusion: All three studies showed that probiotics are safe when used in children and adults with HIV/AIDS. Simple comparison of the studies performed by Trois, et al. and Anukam, et al. suggests that probiotic supplements are more efficacious in adult populations than pediatric populations in reducing frequency of loose stools. However, the use of anti-retroviral drugs, geographic location, probiotic bacterial strain, and the cause of diarrhea in these populations may have impacted the outcomes. More studies containing larger patient sample sizes and including those in various other countries should be performed to further determine the efficacy of probiotics in reducing diarrhea and appreciate other health benefits in diverse populations of HIV-positive individuals. Key words: probiotics, safety, diarrhea, gastrointestinal, children, adults, HIV, AIDS