Roger Paredes.
IRSICaixa AIDS Research Institute, Barcelona, Spain.
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Lesson from the human gut microbiome
Roger Paredes.
IRSICaixa AIDS Research Institute, Barcelona, Spain.
The human intestinal microbiota is essential for human health and well-being and is driven by genetic, lifestyle and environmental factors. The precise effects of HIV-1 on the gut microbiome are unclear. Initial cross-sectional studies provided contradictory associations between microbial richness and HIV serostatus and suggested shifts from Bacteroides to Prevotella predominance following HIV-1 infection, which have not been found in animal models or in studies matched for HIV-1 transmission groups. We demonstrate in two independent cohorts of HIV-1-infected subjects and HIV-1-negative controls in Europe that gay men often have a distinct composition of the human fecal microbiota, with increased microbial richness and diversity and enrichment in the Prevotella enterotype. This is independent of HIV-1 status, and with only a limited contribution of diet effects. After accounting for sexual orientation, however, HIV-1 infection remains associated to reduced bacterial richness, more so in subjects with suboptimal CD4+ T-cell count recovery under antiretroviral therapy. Our findings indicate that all studies of HIV-microbiota relationships should carefully investigate possible confounding or effect modification by sexual orientation, injection drug use, and demographics. They also suggest interventions on gut bacterial richness as possible novel avenues to improve HIV-1-associated immune dysfunction.
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Roger Paredes. MD, PhD, leads the Microbial Genomics Group at the irsiCaixa AIDS Research Institute and is attending HIV physician at the HIV Unit, Hospital Universitari Germans Trias i Pujol in Barcelona, Catalonia, Spain. He’s assistant professor in infectious diseases in the Universitat Autònoma de Barcelona (UAB) and Lecturer in the Chair on AIDS and Related Diseases, UVIC-UCC. His team has made seminal contributions to the current understanding of the clinical relevance of minority drug-resistant HIV and X4 viruses on antiretroviral treatment outcomes and HIV disease progression. He’s now using next-generation genomics to characterize the role of the human microbiome on HIV disease, chronic inflammation and aging. Dr. Paredes is clinical virologist for several European HIV cohorts (EuroSIDA), advisor to the WHO HIV ResNet group and member of the organizing committee of the first International Workshop on Microbiome in HIV Pathogenesis, Prevention and Treatment, held annually in Bethesda, MD.
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