Gut microbiota dysbiosis is associated with worse emotional states in HIV infection

Abstract

The biological mechanisms underlying emotional distress in HIV infection are likely to be complex but remain understudied. We investigated whether dysbiotic signatures in the gut microbiome of persons living with HIV (PLWH) are associated with their emotional status. We retrospectively examined the gut microbiome and clinical evaluation of 129 adults (94 PLWH and 35 HIV-) enrolled at UC San Diego's HIV Neurobehavioral Research Program. A subset of participants (32 PLWH vs. 13 HIV-) underwent an emotional assessment using the NIH Toolbox Emotion Battery summarized by three composite scores (negative affect, social satisfaction, and psychological well-being). We then sequenced the 16S rDNA V3-V4 regions from stool and performed taxonomic assignment using CLC Microbial Genomics Module. The gut microbiota profiles were evaluated in relation to participants' emotional assessment. All analyses were done in R statistical software. We found that the relative abundance of aerotolerant bacteria was significantly higher in PLWH (p < 0.01) and was associated with a lifetime major depression diagnosis independently of HIV status (p = 0.05). Moreover, PLWH experienced significantly worse psychological well-being (p = 0.02), less social satisfaction (p = 0.03), and more negative affect (p = 0.02). Higher levels of aerotolerant bacteria were associated with worse psychological well-being (rho = -0.35, p = 0.02), less social satisfaction (r = - 0.42, p < 0.01), and more negative affect (rho = 0.46, p < 0.01). The association of aerotolerant bacteria with social satisfaction and negative affect was independent of HIV status (p < 0.05, for both). The over-representation of aerotolerant bacteria in the gut may reflect worse oxidative stress and barrier defects and may contribute to emotional distress during HIV infection.

Keywords: Aerotolerant bacteria; Emotional distress; Emotions; Microbiome; Viral infection.

Fig. 1

Summary of study methods. Stool and clinical evaluation were collected from 129 adults (94 PLWH and 35 HIV−). A subset of participants (32 PLWH vs. 13 HIV−) underwent emotional assessment using the NIH toolbox emotion battery. The hypervariable region V3-V4 was amplified from stool DNA and sequenced using the Illumina MiSeq. Bioinformatics and statistical analyses were performed using the CLC Microbial Genomics Module and R statistical Software, respectively

Fig. 2

Levels of aerotolerant bacteria in the gut were significantly higher in a PLWH, b males, c subjects with a lifetime diagnosis of major depressive disorder [LT-MDD], and d subjects with a lifetime diagnosis substance use disorder [LT-SUD]

Fig. 3

PLWH reported significantly more negative affect a, less social satisfaction b, and less psychological well-being c when compared with HIV− subjects. Higher levels of aerotolerant bacteria were associated with more negative affect d, less social satisfaction e, and less psychological well-being f

Fig. 4

a Higher levels of aerotolerant bacteria were associated with more fear affect, b less friendship, c more loneliness, d less meaning and purpose, e more sadness, f less positive affect, and g more perceived stress