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. 2024 Dec 9;19(12):e0308859.
doi: 10.1371/journal.pone.0308859. eCollection 2024.

HIV, the gut microbiome and clinical outcomes, a systematic review

Rachel Mac Cann  1   2   3 , Ellen Newman  2 , Declan Devane  4 , Caroline Sabin  5 , Aoife G Cotter  3   6 , Alan Landay  7 , Paul W O'Toole  8 , Patrick W Mallon  1   2   3
Affiliations

HIV, the gut microbiome and clinical outcomes, a systematic review

Rachel Mac Cann et al. PLoS One. .

Abstract

Background: Effective antiretroviral therapy (ART) has improved the life expectancy of people with HIV (PWH). However, this population is now experiencing accelerated age-related comorbidities, contributed to by chronic immune activation and inflammation, with dysbiosis of the gut microbiome also implicated.

Method: We conducted a systematic literature search of PubMed, Embase, Scopus, Cochrane reviews and international conference abstracts for articles that examined for the following non-communicable diseases (NCDs); cardiovascular disease, cancer, frailty, metabolic, bone, renal and neurocognitive disease, in PWH aged >18 years. Studies were included that measured gut microbiome diversity and composition, microbial translocation markers or microbial metabolite markers.

Results: In all, 567 articles were identified and screened of which 87 full-text articles were assessed for eligibility and 56 were included in the final review. The data suggest a high burden NCD, in particular cardiovascular and metabolic disease in PWH. Alterations in bacterial diversity and structure varied by NCD type, but a general trend in reduced diversity was seen together with alterations in bacterial abundances between different NCD. Lipopolysaccharide was the most commonly investigated marker of microbial translocation across NCD followed by soluble CD14. Short-chain fatty acids, tryptophan and choline metabolites were associated with cardiovascular outcomes and also associated with chronic liver disease (CLD).

Conclusions: This systematic review is the first to summarise the evidence for the association between gut microbiome dysbiosis and NCDs in PWH. Understanding this interaction will provide insights into the pathogenesis of many NCD and help develop novel diagnostic and therapeutic strategies for PWH.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
Flow chart of study selection process.
Fig 2
Fig 2. Interrelationships between gut dysbiosis, inflammation and non-communicable diseases (NCDs).
The gut microbiota is shaped by various host factors and has a bidirectional relationship with inflammation, and depending on its composition, it can inhibits or stimulate inflammatory pathways. These, in turn, can promote the onset of various inflammatory conditions such as NCDs.
See this image and copyright information in PMC

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