Shrivastav Komal, Nasser Hesham, Ikeda Terumasa, Nema Vijay
Division of Molecular Biology, ICMR-National Institute of Translational Virology and AIDS Research (Formerly NARI), Pune 411026, India.
Division of Molecular Virology & Genetics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan.
Viruses. 2025 Jul 16;17(7):990. doi: 10.3390/v17070990.
Improved antiretroviral therapy (ART) has significantly increased the life expectancy of people living with HIV (PLWH). At the same time, other complications like metabolic syndrome (MetS) are coming up as new challenges to handle. This review aims to explore the emerging evidence of gut microbiome and virome alterations in human immunodeficiency virus-1 (HIV-1) infection and associated metabolic disorders, such as type-2 diabetes (T2DM) and cardiovascular disease (CVD), with a focus on their interplay, contribution to immune dysfunction, and potential as therapeutic targets. We conducted a comprehensive review of the current literature on gut bacteriome and virome changes in HIV-1-infected individuals and those with metabolic comorbidities emphasizing their complex interplay and potential as biomarkers or therapeutic targets. HIV-1 infection disrupts gut microbial homeostasis, promoting bacterial translocation, systemic inflammation, and metabolic dysregulation. Similarly, metabolic disorders are marked by reduced beneficial short-chain fatty acid-producing bacteria and an increase in pro-inflammatory taxa. Alterations in the gut virome, particularly involving bacteriophages, may exacerbate bacterial dysbiosis and immune dysfunction. Conversely, some viral populations have been associated with immune restoration post-ART. These findings point toward a dynamic and bidirectional relationship between the gut virome, bacteriome, and host immunity. Targeted interventions such as microbiome modulation and fecal virome transplantation (FVT) offer promising avenues for restoring gut homeostasis and improving long-term outcomes in PLWH.
改进的抗逆转录病毒疗法（ART）显著提高了人类免疫缺陷病毒（HIV）感染者（PLWH）的预期寿命。与此同时，诸如代谢综合征（MetS）等其他并发症正成为新的应对挑战。本综述旨在探讨人类免疫缺陷病毒1型（HIV-1）感染及相关代谢紊乱（如2型糖尿病（T2DM）和心血管疾病（CVD））中肠道微生物群和病毒组改变的新证据，重点关注它们之间的相互作用、对免疫功能障碍的影响以及作为治疗靶点的潜力。我们对当前关于HIV-1感染者和有代谢合并症者肠道细菌组和病毒组变化的文献进行了全面综述，强调了它们之间复杂的相互作用以及作为生物标志物或治疗靶点的潜力。HIV-1感染破坏肠道微生物稳态，促进细菌易位、全身炎症和代谢失调。同样，代谢紊乱的特征是有益的产生短链脂肪酸的细菌减少，促炎类群增加。肠道病毒组的改变，特别是涉及噬菌体的改变，可能会加剧细菌生态失调和免疫功能障碍。相反，一些病毒群体与ART后的免疫恢复有关。这些发现表明肠道病毒组、细菌组和宿主免疫之间存在动态双向关系。微生物群调节和粪便病毒组移植（FVT）等靶向干预措施为恢复肠道稳态和改善PLWH的长期预后提供了有希望的途径。
