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               <mods:identifier type="citation">Front Pediatr. 2022 Jul 19;10:919753.</mods:identifier>
               <mods:identifier type="doi">10.3389/fped.2022.919753</mods:identifier>
               <mods:identifier type="issn">2296-2360</mods:identifier>
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               <mods:abstract>Aims: Vaccine response is poor among children living with HIV. The gut microbiota has been identified as a potential target to improve vaccine immunogenicity, but data are scarce in the context of HIV infection. Methods: Pilot, double-blind, randomized placebo-controlled trial in which 24 HIV-infected children were randomized to receive a mixture of symbiotics, omega-3/6 fatty acids, and amino acids or placebo for 4 weeks, each in combination with ART, and were then immunized against influenza. Vaccine response and safety of the nutritional supplementation were the primary outcomes. Results: Eighteen HIV-infected children completed the follow-up period (mean age 11.5 ± 4.14 years, 61% female). The nutritional supplement was safe but did not enhance the response to the influenza vaccine. A 4-fold rise in antibody titers was obtained in only 37.5% of participants in the intervention arm vs. 40% in the placebo. No immunological or inflammatory predictors of vaccine response were identified. Conclusions: In this exploratory study, a 4-week course of symbiotics did not increase influenza vaccine immunogenicity in HIV-infected children. Larger studies are warranted to address the potential of modulating the microbiome in children living with HIV.</mods:abstract>
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                  <mods:topic>HIV</mods:topic>
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                  <mods:topic>Immunoactivation</mods:topic>
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                  <mods:topic>Influenza vaccine response</mods:topic>
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                  <mods:title>Nutritional Supplementation to Increase Influenza Vaccine Response in Children Living With HIV: A Pilot Clinical Trial</mods:title>
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