Alteration in Oral Microbiome Among Men Who Have Sex With Men With Acute and Chronic HIV Infection on Antiretroviral Therapy.

Hao Wu,Shuang Li,Qiuyue Zhang,Huanhuan Wei,Jiaqi Wei,Bin Su,Junping Zhu,Tong Zhang,Fei Chen,Qiushui He,Hongshan Liu,Wei Xia,Xiaodong Yang

doi:10.3389/fcimb.2021.695515

Abstract

Despite the antiretroviral therapy (ART), human immunodeficiency virus (HIV)-related oral disease remains a common problem for people living with HIV (PLWH). Evidence suggests that impairment of immune function in HIV infection might lead to the conversion of commensal bacteria to microorganisms with increased pathogenicity. However, limited information is available about alteration in oral microbiome in PLWH on ART. We performed a longitudinal comparative study on men who have sex with men (MSM) with acute HIV infection (n=15), MSM with chronic HIV infection (n=15), and HIV-uninfected MSM controls (n=15). Throat swabs were collected when these subjects were recruited (W0) and 12 weeks after ART treatment (W12) from the patients. Genomic DNAs were extracted and 16S rRNA gene sequencing was performed. Microbiome diversity was significantly decreased in patients with acute and chronic HIV infections compared with those in controls at the sampling time of W0 and the significant difference remained at W12. An increased abundance of unidentified Prevotellaceae was found in patients with acute and chronic HIV infections. Moreover, increased abundances of Prevotella in subjects with acute HIV infection and Streptococcus in subjects with chronic HIV infection were observed. In contrast, greater abundance in Lactobacillus, Rothia, Lautropia, and Bacteroides was found in controls. After effective ART, Bradyrhizobium was enriched in both acute and chronic HIV infections, whereas in controls, Lactobacillus, Rothia, Clostridia, Actinobacteria, and Ruminococcaceae were enriched. In addition, we found that lower CD4+ T-cell counts (<200 cells/mm3) were associated with lower relative abundances of Haemophilus, Actinomyces, unidentified Ruminococcaceae, and Rothia. This study has shown alteration in oral microbiome resulting from HIV infection and ART. The results obtained warrant further studies in a large number of subjects with different ethnics. It might contribute to improved oral health in HIV-infected individuals.

Highlights

Human immunodeficiency virus (HIV) infection is characterized by rapid and substantial loss of CD4+ T cells that impairs host defense and increases the risk of opportunistic microbial infections
Our present study clearly showed that the Operational taxonomic units (OTUs) identified in oral microbiome in people living with acute or chronic HIV infection were significantly lower compared with those in controls, and the number of OTUs in patients did not return to normal level even after 12 weeks of antiretroviral therapy (ART)
It is conceivable that the impaired immune function resulting from HIV infection can disrupt the normally constituted commensal oral bacterial colonization, and the elevated viremia in untreated people living with HIV infection (PLWH) is associated with significantly higher proportions of potentially pathogenic Veillonella, Prevotella, Megasphaera, and Campylobacter species than in healthy controls (Dang et al, 2012)

Summary

Introduction

Human immunodeficiency virus (HIV) infection is characterized by rapid and substantial loss of CD4+ T cells that impairs host defense and increases the risk of opportunistic microbial infections. Alterations in the gut microbiota will eventually lead to an imbalance between microbes and their metabolites and could result in HIV-associated immune activation and inflammation (Dinh et al, 2015; Zevin et al, 2016). In HIV infection, the observed loss of Th17 cells results in impaired integrity of the mucosal epithelial barriers, leading to microbial translocation from the gut lumen into the systemic circulation (Brenchley et al, 2006; Mudd and Brenchley, 2016). Annavajhala et al have shown that oral microbiome communities likely contribute to systemic inflammation and immune activation in PLWH (Annavajhala et al, 2020). Data are still limited about alterations in oral microbiome in HIV infection on ART

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