Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Feb;30(1):31-43.
doi: 10.1097/QCO.0000000000000341.

HIV-associated changes in the enteric microbial community: potential role in loss of homeostasis and development of systemic inflammation

David B Gootenberg  1 , Jeffrey M Paer, Jesus-Mario Luevano, Douglas S Kwon
Affiliations
Review

HIV-associated changes in the enteric microbial community: potential role in loss of homeostasis and development of systemic inflammation

David B Gootenberg et al. Curr Opin Infect Dis. 2017 Feb.

Abstract

Purpose of review: Despite HIV therapy advances, average life expectancy in HIV-infected individuals on effective treatment is significantly decreased relative to uninfected persons, largely because of increased incidence of inflammation-related diseases, such as cardiovascular disease and renal dysfunction. The enteric microbial community could potentially cause this inflammation, as HIV-driven destruction of gastrointestinal CD4 T cells may disturb the microbiota-mucosal immune system balance, disrupting the stable gut microbiome and leading to further deleterious host outcomes.

Recent findings: Varied enteric microbiome changes have been reported during HIV infection, but unifying patterns have emerged. Community diversity is decreased, similar to pathologies such as inflammatory bowel disease, obesity, and Clostridium difficile infection. Many taxa frequently enriched in HIV-infected individuals, such as Enterobacteriaceae and Erysipelotrichaceae, have pathogenic potential, whereas depleted taxa, such as Bacteroidaceae and Ruminococcaceae, are more linked with anti-inflammatory properties and maintenance of gut homeostasis. The gut viral community in HIV has been found to contain a greater abundance of pathogenesis-associated Adenoviridae and Anelloviridae. These bacterial and viral changes correlate with increased systemic inflammatory markers, such as serum sCD14, sCD163, and IL-6.

Summary: Enteric microbial community changes may contribute to chronic HIV pathogenesis, but more investigation is necessary, especially in the developing world population with the greatest HIV burden (Video, Supplemental Digital Content 1, http://links.lww.com/COID/A15, which includes the authors' summary of the importance of the work).

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Alterations in the gut microbiota reported in HIV microbiome studies. Black and gray boxes, respectively, indicate reported increases and decreases in relative abundance. Bracketed letter indicates taxonomic level of classification (e.g., [p] indicates phylum), parenthetical taxa indicate subtaxa that commonly drive significance of parent taxa. aDysbiosis observed in HIV-positive subjects with less than 200 CD4+ T cells/μL. Black dashed box outlines the only study to date that investigated the relationship between gut microbiota and HIV in a sub-Saharan African cohort. bFecal microbiome data only obtained for HIV seronegative unexposed and exposed infants. cProteobacteria class indicated by corresponding Greek letter (e.g., β for Betaproteobacteria). Enterobacteriaceae are Gammaproteobacteria [c] within Proteobacteria [p]. ART, antiretroviral therapy.
Box 1
Box 1
no caption available
FIGURE 2
FIGURE 2
Study design and patient metadata in HIV microbiome studies. ∗CD4 cell counts (cells/μL) displayed as either median [range (not notated in table)] median (IQR), or average ± SD. †Sex composition of clinical study participant groups not specified. aThe same patient cohort was used for both Lozupone et al. 2013 and 2014. Displayed is patient information from Lozupone et al. 2014, which included 17 additional subjects. Proportion of males versus females in each clinical group is only described in Lozupone et al. 2013 (male/female: 8/5 seronegative; 11/0 HIV+ untreated; 7/1 HIV+ treated). bThe black dashed box outlines the only study to date that investigated the relationship between gut microbiota and HIV in a sub-Saharan African cohort. cFecal microbiome data only obtained for HIV seronegative unexposed and exposed infants. dThe HIV-infected group has a total of 31 individuals, including 22 males and 9 females, specific clinical group not specified. eThirty study participants (22 males, 8 females) originally enrolled but only 24 study participants completed the study, specific clinical group not specified. fThe HIV-infected groups of the Barcelona and Stockholm cohorts, respectively, included 101 males and 28 females, and 46 males and 31 females, specific clinical group not specified. gImmunological responders (IR) and nonresponders (INR) respectively defined as having at least 350 and less than 350 CD4+ T-cell counts/μl after more than 2 years of ART. ART, antiretroviral therapy.
FIGURE 3
FIGURE 3
People living with HIV and locations of HIV-microbiome studies. Locations of HIV-microbiome cohorts overlaid on world map of HIV prevalence. The vast majority of HIV-microbiome studies have been conducted in developed world settings. Map source: Adults and children estimated to be living with HIV 2015, WHO/UNAIDS/UNICEF.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Delwart E. A roadmap to the human virome. PLoS Pathog 2013; 9:e1003146. - PMC - PubMed
    1. Ley RE, Peterson DA, Gordon JI. Ecological and evolutionary forces shaping microbial diversity in the human intestine. Cell 2006; 124:837–848. - PubMed
    1. Virgin HW, Todd JA. Metagenomics and personalized medicine. Cell 2011; 147:44–56. - PMC - PubMed
    1. Virgin HW, Wherry EJ, Ahmed R. Redefining chronic viral infection. Cell 2009; 138:30–50. - PubMed
    1. Wylie KM, Weinstock GM, Storch GA. Emerging view of the human virome. Transl Res 2012; 160:283–290. - PMC - PubMed