Infectious Diseases Unit, S. Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Curr Opin HIV AIDS. 2018 Jan;13(1):73-80. doi: 10.1097/COH.0000000000000429.
Aim of this review is to summarize the alterations occurring in gut microbiome composition after HIV infection, and to underline how intestinal dysbiosis can affect immune homeostasis, immune recovery, and persisting immune activation under antiretroviral therapy (ART). Many interventions have been suggested, mostly with inconclusive results.
Recent evidence showed that gut microbiota from HIV-infected patients harbor reproducible differences compared to uninfected individuals. In this line, there is growing evidence that alterations in gut ecology during HIV infection correlate with persistence of immune defects and chronic inflammation. A reduced microbial diversity in feces of HIV-infected patients is highly associated with microbial translocation and monocyte activation markers; moreover, changes in mucosa-associated bacteria correlate with inflammation and T-cell activation.
Studying the human host-microbiota interaction suggests that the consequences of HIV infection on microbial composition can influence immune status in HIV patients. ART induces microbiome changes that are independent of HIV infection, and some imply that ART may enhance dysbiosis. Studies and trials evaluated the effects of administering probiotics and prebiotics, finding a potential benefit on inflammation markers and immune cell activation. Emerging data on fecal microbial transplantation need to be assessed with further studies.
本综述旨在总结 HIV 感染后肠道微生物组组成的变化，并强调肠道菌群失调如何影响抗逆转录病毒治疗（ART）下的免疫稳态、免疫恢复和持续免疫激活。已经提出了许多干预措施，但大多结果并不明确。
最近的证据表明，与未感染个体相比，HIV 感染患者的肠道微生物群具有可重复的差异。在这方面，越来越多的证据表明，HIV 感染期间肠道生态的改变与免疫缺陷和慢性炎症的持续存在相关。HIV 感染患者粪便中的微生物多样性减少与微生物易位和单核细胞激活标志物高度相关；此外，黏膜相关细菌的变化与炎症和 T 细胞激活相关。
研究人类宿主-微生物群相互作用表明，HIV 感染对微生物组成的影响可能会影响 HIV 患者的免疫状态。ART 诱导的微生物组变化独立于 HIV 感染，其中一些表明 ART 可能会加剧菌群失调。研究和试验评估了给予益生菌和益生元的效果，发现它们对炎症标志物和免疫细胞激活有潜在益处。需要进一步研究来评估粪便微生物移植的新兴数据。
