Sainz, TaliaCasas Flecha, InmaculadaGonzález-Esguevillas, MónicaEscosa-Garcia, LuisMuñoz-Fernández, María ÁngelesPrieto, LuisGosalbes, María JoséJiménez-Hernández, NuriaRamos, José TomásNavarro, María LuisaMellado, María JoséSerrano-Villar, SergioCalvo, Cristina2022-12-202022-12-202022-07-19Front Pediatr. 2022 Jul 19;10:919753.2296-2360http://hdl.handle.net/20.500.12105/15291Final results of this work have been presented at the following meetings: 36rd Annual Meeting of the European Society for Pediatric Infectious Diseases (ESPID 2018), Malmö, Sweden, 28th May-June 2nd, 2018. (Ref. ESP18-0517).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.engVoRhttp://creativecommons.org/licenses/by/4.0/HIVChildrenImmunoactivationInfluenza vaccine responseMicrobiotaAtribución 4.0 Internacional359286881091975310.3389/fped.2022.919753Frontiers In Pediatricsopen access