Gut Microbiota, Inflammation, and Cardiovascular Risk in HIV Infection
Overview
This study reveals significant differences in gut microbiota composition between people with and without HIV, linking these differences to systemic inflammation and subclinical cardiovascular disease (CVD). Specific bacterial species were correlated with plaque burden and inflammatory biomarkers, highlighting the microbiome's role in cardiovascular risk among individuals living with HIV.
Background
Despite effective antiretroviral therapy (ART), people living with HIV experience chronic inflammation and an increased risk of age-related diseases such as cardiovascular disease (CVD). Traditional CVD risk factors do not fully explain this elevated risk. Gut dysbiosis, characterized by altered microbial diversity and depletion of beneficial short chain fatty acid (SCFA)-producing bacteria, has been implicated in systemic inflammation and immune activation in HIV. Understanding the interplay between gut microbiota, inflammation, and CVD may provide insights into premature aging and cardiovascular risk in this population.
People with HIV exhibited distinct gut microbiome β-diversity compared to those without HIV.
Enrichment of Bifidobacterium pseudocatenulatum, Megamonas hypermegale, and Selenomonas ruminantium was associated with lower coronary plaque burden.
Depletion of Ruminococcus bromii correlated with higher plaque burden and increased dietary fat intake.
Reduced abundance of Bacteroides and Alistipes species correlated with elevated systemic inflammatory biomarkers including D-dimer and C-reactive protein.
Gut microbiota alterations in HIV were linked to subclinical cardiovascular disease, diet, and systemic inflammation.
Clinical Implications
These findings suggest that gut microbiota composition plays a significant role in modulating inflammation and cardiovascular risk in people living with HIV. Monitoring and potentially modulating gut microbiota may offer novel strategies to reduce CVD risk in this population. Clinicians should consider the impact of diet and microbial health when managing cardiovascular risk in HIV-infected individuals.
Conclusion
The study highlights the interconnectedness of gut microbiota alterations, systemic inflammation, and subclinical cardiovascular disease in people with HIV. Targeting the gut microbiome may represent a promising avenue for mitigating cardiovascular risk in this population.
References
HIV UPBEAT Coronary Artery Disease sub-study -- Links Among Gut Microbiota, Inflammatory Responses, and Cardiovascular Health in Individuals Living with HIV
by Rachel MacCann, Junhui Li, Alejandro Abner Garcia Leon, Riya Negi, Dana Alalwan, Willard Tinago, Padraig McGettrick, Aoife G Cotter, Alan Landay, Caroline Sabin, Paul W O’Toole, Patrick W G Mallon, for the Understanding the Pathology of Comorbid Disease in HIV-Infected Individuals (HIV UPBEAT) Study Group, Padraig McGettrick, Elena Alvarez Barco, Willard Tinago, Alejandro Garcia Leon, Aoife McDermott, Tara McGinty, Aoife G Cotter, Alan Macken, Patrick W G Mallon, Eoin Kavanagh, Geraldine McCarthy, Gerard Sheehan, John Lambert, William Powderly, Juliet Compston, Caroline Sabin
