{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:25:38Z","timestamp":1789640738398,"version":"4.0.0"},"reference-count":93,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Gut microbiota play important roles in several diseases like viral infections. In this systematic review, our objective was to assess the efficacy and safety of fecal microbiota transplantation (FMT) in treating various viral diseases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted searches on databases including PubMed, Web of Science, Scopus, and Google Scholar until November 2023. Clinical trials reported outcomes related to safety of FMT or its efficacy in patients with viral diseases were included. We excluded other types of studies that enrolled healthy individuals or patients with other disorders and did not use FMT. The assessment of bias risk was conducted using the National Institutes of Health (NIH) study quality evaluation tool.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Eight studies with total 196 participants were included. Viral diseases were human immunodeficiency virus (HIV), hepatitis B, COVID-19 and Clostridioides difficile coinfection, and cytomegalovirus colitis. In hepatitis B cases, HBeAg clearance was significant in those received FMT (p&lt;0.01), while it was not significant in another one (p = 0.19). A clinical response was noted in 37.5% of patients with cytomegalovirus colitis, with an equal percentage achieving clinical remission post-FMT. There was a significant reduction in Clostridioides difficile relapse rate in FMT group than controls in coinfection of Clostridioides difficile and COVID-19 (2.17% vs. 42.5%, p&lt;0.05). In patients with HIV, partial engraftment of the donor microbiome and increases in alpha diversity were observed after FMT. No severe adverse events were reported. Most studies had fair or good qualities.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our findings revealed FMT as a promising, safe treatment for some viral diseases. It improved viral clearance, clinical outcomes, and inflammation. However, the varying responses and small sample sizes call for more trials on FMT in viral diseases.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0311731","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T17:23:22Z","timestamp":1729531402000},"page":"e0311731","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Safety and efficacy of fecal microbiota transplantation for viral diseases: A systematic review of clinical trials"],"prefix":"10.1371","volume":"19","author":[{"given":"Rasoul","family":"Ebrahimi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Mahdi","family":"Masouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Abbas","family":"Salehi Amniyeh Khozani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Ramadhan Hussein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-9720","authenticated-orcid":true,"given":"Seyed Aria","family":"Nejadghaderi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"issue":"11","key":"pone.0311731.ref001","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1042\/BCJ20160510","article-title":"Introduction to the human gut microbiota","volume":"474","author":"E Thursby","year":"2017","journal-title":"Biochem J"},{"issue":"1","key":"pone.0311731.ref002","first-page":"56","article-title":"Faecal Microbiota Transfer \u2010 a new concept for treating cytomegalovirus colitis in children with ulcerative colitis","volume":"28","author":"K Karolewska-Bochenek","year":"2021","journal-title":"Ann Agric Environ Med"},{"issue":"1","key":"pone.0311731.ref003","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/s41392-022-00974-4","article-title":"Microbiota in health and diseases","volume":"7","author":"K Hou","year":"2022","journal-title":"Signal Transduction and Targeted Therapy"},{"issue":"4","key":"pone.0311731.ref004","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1038\/nri.2017.7","article-title":"Dysbiosis and the immune system","volume":"17","author":"M Levy","year":"2017","journal-title":"Nat Rev Immunol"},{"key":"pone.0311731.ref005","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.3389\/fimmu.2019.01551","article-title":"The Commensal Microbiota and Viral Infection: A Comprehensive Review","volume":"10","author":"N Li","year":"2019","journal-title":"Front Immunol"},{"key":"pone.0311731.ref006","first-page":"10","article-title":"Viral Infections, the Microbiome, and Probiotics","author":"A Harper","year":"2021","journal-title":"Frontiers in Cellular and Infection Microbiology"},{"issue":"1","key":"pone.0311731.ref007","doi-asserted-by":"crossref","first-page":"e0070821","DOI":"10.1128\/Spectrum.00708-21","article-title":"Unique Gut Microbiome in HIV Patients on Antiretroviral Therapy (ART) Suggests Association with Chronic Inflammation","volume":"9","author":"A Ishizaka","year":"2021","journal-title":"Microbiol Spectr"},{"issue":"8","key":"pone.0311731.ref008","doi-asserted-by":"crossref","first-page":"4151","DOI":"10.1007\/s00394-021-02519-x","article-title":"Modulation of gut microbiota protects against viral respiratory tract infections: a systematic review of animal and clinical studies","volume":"60","author":"HY Shi","year":"2021","journal-title":"Eur J Nutr"},{"key":"pone.0311731.ref009","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.cca.2019.12.010","article-title":"Fecal microbiota transplantation in disease therapy","volume":"503","author":"H. 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