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HIV, Sexual Orientation, and Gut Microbiome Interactions

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Abstract

Recent studies have raised interest in the possibility that dysbiosis of the gut microbiome (i.e., the communities of bacteria residing in the intestine) in HIV-infected patients could contribute to chronic immune activation, and, thus, to elevated mortality and increased risk of inflammation-related clinical diseases (e.g., stroke, cardiovascular disease, cancer, long-bone fractures, and renal dysfunction) found even in those on effective antiretroviral therapy. Yet, to date, a consistent pattern of HIV-associated dysbiosis has not been identified. What is becoming clear, however, is that status as a man who has sex with men (MSM) may profoundly impact the structure of the gut microbiota, and that this factor likely confounded many HIV-related intestinal microbiome studies. However, what factor associated with MSM status drives these gut microbiota-related changes is unclear, and what impact, if any, these changes may have on the health of MSM is unknown. In this review, we outline available data on changes in the structure of the gut microbiome in HIV, based on studies that controlled for MSM status. We then examine what is known regarding the gut microbiota in MSM, and consider possible implications for research and the health of this population. Lastly, we discuss knowledge gaps and needed future studies.

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Funding

ST is supported by NIH grant K23-AI125715 (PI: Tuddenham). CLS is supported, in part, by funds of the Johns Hopkins University School of Medicine and Department of Medicine. ST and CLS’ work on HIV and gut microbiome has been supported by a Willowcroft Foundation grant (to ST) and two developmental Grants (to ST and to CLS) from the Johns Hopkins University Center for AIDS Research (JHU-CFAR), an NIH-funded program (P30AI094189). WK’s work on HIV and gut microbiome is supported by developmental grants from the Clinical Translational Science Institution at Children’s National (CTSI-CN) and the District of Columbia CFAR (DC CFAR), an NIH-funded program (AI117970). Both JHU-CFAR and DC CFAR are supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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  1. Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Susan Tuddenham & Cynthia Sears

  2. Department of Infectious Disease, Children’s National Hospital, Washington, DC, USA

    Wei Li Koay

  3. School of Medicine and Health Sciences, George Washington University, Washington, DC, USA

    Wei Li Koay

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  1. Susan Tuddenham
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  2. Wei Li Koay
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  3. Cynthia Sears
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Correspondence to Susan Tuddenham.

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ST has consulted for Biofire Diagnostics and Roche Molecular Diagnostics and has received a speaker honorarium from Roche Molecular Diagnostics. CLS receives unrelated research support from Bristol Myers Squibb and Janssen and received a speaker honorarium from Merck in 2019.

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Tuddenham, S., Koay, W.L. & Sears, C. HIV, Sexual Orientation, and Gut Microbiome Interactions. Dig Dis Sci 65, 800–817 (2020). https://doi.org/10.1007/s10620-020-06110-y

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