Composition of gut microbiota of children and adolescents with perinatal HIV infection taking antiretroviral therapy in Zimbabwe

Abstract

<p><i>Background - </i>Human immunodeficiency virus (HIV) infection causes impairment of the gastrointestinal barrier, with substantial depletion of CD4⁺ T cells in the gut. Antiretroviral therapy (ART) restores CD4⁺ counts and may have beneficial effects on gut microbiota in adults. Little is known about effect of long-term ART on gut microbiome in HIV-infected children. We investigated composition of gut microbiota in HIV-infected and -uninfected children and assessed associations between gut microbiota and patient characteristics. <p><i>Methods - </i>In a cross-sectional study, rectal swabs were collected from 177 HIV-infected and 103 HIV-uninfected controls. Gut microbial composition was explored using 16S ribosomal ribonucleic acid sequencing. <p><i>Results - </i>Human immunodeficiency virus-infected children had significantly lower alpha-diversity and higher beta-diversity compared to HIV-uninfected. No association was observed between microbiome diversity and CD4⁺ T-cell count, HIV viral load, or HIV-associated chronic lung disease. We found enriched levels of <i>Corynebacterium</i> (<i>P</i> < .01), <i>Finegoldia</i> (<i>P</i> < .01), and <i>Anaerococcus</i> (<i>P</i> < .01) in HIV-infected participants and enrichment of <i>Enterobacteriaceae</i> (<i>P</i> = .02) in participants with low CD4⁺ counts (<400 cells/mm³). Prolonged ART-treatment (≥10 years) was significantly associated with a richer gut microbiota by alpha diversity. <p><i>Conclusions - </i>Human immunodeficiency virus-infected children have altered gut microbiota. Prolonged ART may restore the richness of the microbiota closer to that of HIV-uninfected children.