Gut Lactobacillales are associated with higher CD4 and less microbial translocation during HIV infection

• DOI: 10.1097/qad.0b013e3283611816
• Publication Date: 2013-03-22T22:25:46Z
• Authors: Josué Pérez-Santiago; Sara Gianella; Marta Massanella; Celsa A. Spina; Maile Y. Karris; Susanna R. Var; Derek Patel; Parris S. Jordan; Jason A. Young; Susan J. Little; Douglas D. Richman; Davey M. Smith
• Keywords: CD4-Positive T-Lymphocytes; Male; 0301 basic medicine; Biomedical and clinical sciences; gut microbiome; HIV Infections; Medical and Health Sciences; Maraviroc; Placebos; gut-associated lymphoid tissue; Combination/methods Gastrointestinal Tract/*microbiology HIV Infections/*complications/*immunology Humans Lactobacillales/*growth & development Male Maraviroc Middle Aged Placebos/administration & dosage Rectum/microbiology Triazoles/therapeutic use Young Adult; Lactobacillales; Biological Sciences; Middle Aged; Biota; 3. Good health; Infectious Diseases; pyrosequencing; Anti-Retroviral Agents; Medical Microbiology; 6.1 Pharmaceuticals; Combination; HIV/AIDS; Drug Therapy, Combination; Infection; Adult; microbial translocation; Immunology; Clinical Trials and Supportive Activities; 610; immune activation; Young Adult; 03 medical and health sciences; Drug Therapy; Double-Blind Method; Clinical Research; Cyclohexanes; Virology; 616; Humans; Biomedical and Clinical Sciences; Bacteria; Psychology and Cognitive Sciences; Rectum; Health sciences; Adult Anti-Retroviral Agents/therapeutic use Bacteria/classification/genetics Bacterial Translocation/*immunology Biota CD4 Lymphocyte Count CD4-Positive T-Lymphocytes/*immunology Cyclohexanes/therapeutic use Double-Blind Method Drug Therapy; Triazoles; CD4 Lymphocyte Count; Gastrointestinal Tract; Bacterial Translocation; Sexually Transmitted Infections; Microbiome

Early HIV infection is characterized by a dramatic depletion of CD4 T cells in the gastrointestinal tract and translocation of bacterial products from the gut into the blood. In this study, we evaluated if gut bacterial profiles were associated with immune status before and after starting antiretroviral therapy (ART).We evaluated the gut microbiota of men recently infected with HIV (n = 13) who were participating in a randomized, double-blind controlled trial of combination ART and maraviroc versus placebo and who were followed for 48 weeks.To evaluate the gut microbiota of participants, we pyrosequenced the bacterial populations from anal swabs collected before and longitudinally after the initiation of ART. Associations of the gut flora with clinical variables (lymphocyte profiles and viral loads), activation and proliferation markers in peripheral blood mononuclear cells and gut biopsies (measured by flow cytometry) and markers of microbial translocation (lipopolysaccharide and soluble CD14) were performed by regression analyses using R statistical software.Using pyrosequencing, we identified that higher proportions of Lactobacillales in the distal gut of recently HIV-infected individuals were associated with lower markers of microbial translocation, higher CD4% and lower viral loads before ART was started. Similarly, during ART, higher proportions of gut Lactobacillales were associated with higher CD4%, less microbial translocation, less systemic immune activation, less gut T lymphocyte proliferation, and higher CD4% in the gut.Shaping the gut microbiome, especially proportions of Lactobacillales, could help to preserve immune function during HIV infection.