Intestinal microbiota in hiv-infected patientsand effects of antiretroviral treatments on microbiota

Aim: Our study aims to examine the gut microbiota in newly diagnosed HIV/AIDS patients, to compare these data with healthy volunteers, and to determine the intestinal microbiota change with the antiretroviral treatment started in the patients. Materials and Methods: Patients with newly diagnosed HIV/AIDS who applied to Dicle University Medical Faculty Infectious Diseases Clinical Microbiology Department Polyclinics and Clinics between December 2021 and May 2022 were included in the baseline patient group of the study. The patients were re-examined in the 3rd month after the treatment and were included in the control patient group of the study. The third group of the study consisted of the healthy control group. For intestinal microbiota analysis, stool samples were taken from all participants and analyzed by the next-generation sequencing method. In the analysis of the data, IBM SPSS Statistics 26 (IBM SPSS, Türkiye) program was used. Results: Fifteen HIV/AIDS patients and 10 healthy volunteers were included in the study. Of the 25 subjects included in the study, 21 (84%) were male and 4 (16%) were female. The mean age of the participants was 35.4±9.1 years, the youngest participant was 21 years old and the oldest was 50 years old. In the baseline patient group, HIV RNA was measured as an average of 568,740 copies/ml. The lowest HIV RNA count was 354 copies/ml; the highest was detected as 4 430 860 copies/ml. In the baseline patient group, the mean CD4+ T lymphocyte count was 352 cells/mm3, while the lowest was 139 cells/mm3; the highest was determined as 650 cells/mm3. In the patient control group, HIV RNA was measured as 364 copies/ml on average. The lowest HIV RNA was 0 copies/ml; the highest was determined as 5 503 copies/ml. In the patient control group, the mean number of CD4+ T lymphocytes was 622 cells/mm3, while the lowest was 160 cells/mm3; the highest was found to be 1 400 cells/mm3. There was no significant relationship between treatment regimens and CD4+ T lymphocyte change and HIV RNA count. There was an increase in Actinobacteria phylum in the patient baseline group compared to the healthy control group. A decrease in Actinobacteria phylum was detected in the patient control group compared to the patient baseline group. There was an increase in the number of Bacteroides, Oxalobacter, Neisseria, Collinsella, Pseudomonas, and Streptococcus in the patient baseline group compared to the patient control group. In the treatment comparison in the patient control group, a significant increase was found in the Spirochaetes phylum and Veillonellaceae family in the Emtricitabine, TDF, and dolutegravir groups, and Oxalobacter at the genus level. Conclusion: Intestinal microbiota is affected by HIV/AIDS disease. Microorganism diversity decreases with the disease. Differentiation of microorganisms plays a role in inflammation. The treatment started, and an increase in the number of CD4 + T cells and a decrease in HIV RNA change the diversity of microorganisms. In these patients, it is of great importance that the treatment is under control, with nutrition and exercise support.