HIV-associated gut dysbiosis is independent of sexual practice and correlates with noncommunicable diseases

Abstract

Loss of gut mucosal integrity and an aberrant gut microbiota are proposed mechanisms contributing to chronic inflammation and increased morbidity and mortality during antiretroviral-treated HIV disease. Sexual practice has recently been uncovered as a major source of microbiota variation, potentially confounding prior observations of gut microbiota alterations among persons with HIV (PWH). To overcome this and other confounding factors, we examine a well-powered subset of AGEhIV Cohort participants comprising antiretroviral-treated PWH and seronegative controls matched for age, body-mass index, sex, and sexual practice. We report significant gut microbiota differences in PWH regardless of sex and sexual practice including Gammaproteobacteria enrichment, Lachnospiraceae and Ruminococcaceae depletion, and decreased alpha diversity. Men who have sex with men (MSM) exhibit a distinct microbiota signature characterized by Prevotella enrichment and increased alpha diversity, which is linked with receptive anal intercourse in both males and females. Finally, the HIV-associated microbiota signature correlates with inflammatory markers including suPAR, nadir CD4 count, and prevalence of age-associated noncommunicable comorbidities.

Non-Invasive Plasma Glycomic and Metabolic Biomarkers of Post-treatment Control of HIV

“…68 Impaired intestinal barrier integrity is a classical feature of HIV infection, characterized by dysbiosis and increased microbial by-products that drive systemic and mucosal in ammation. 69,70 Microbes with the capacity to catabolize tryptophan have been linked to adverse HIV disease progression, 71 at least in part due to induction of IDO1 that interferes with Th17/Treg balance in the periphery and gut. 72 Our data highlight previously unrecognized interactions between the gut microbiome, its metabolic activity, and HIV persistence.…”

Cannabis and the Gut–Brain Axis Communication in HIV Infection

“…The abundance of P. copri and Prevotella stercorea in PWH has been evaluated in numerous studies and found to be associated with sexual behavior rather than solely HIV status. 47 A few studies examining HIV microbial dysbiosis have been conducted with a majority of men who have sex with men ( MSM). In these studies, there has been an association with sexual orientation and an abundance of Prevotella enterotype in contrast to men who have sex with women who are rich in Bacteroides.…”

Managing HIV‐associated inflammation and ageing in the era of modern ART

“…The release of bacterial products provokes a persistent, systemic activation of the innate immune system that triggers and maintains inflammation [34–37]. ART does not completely reverse the damage to the gut mucosal epithelia during early HIV infection nor does it completely restore HIV‐associated microbial dysbiosis [38–41].…”