Gut Microbiota Dysbiosis Is Not Independently Associated With Neurocognitive Impairment in People Living With HIV.

Fengdi Zhang,Meiyan Sun,Hongzhou Lu,Li Liu,Junyang Yang,Jiayin Shen,Yinzhong Shen,Renfang Zhang,Jiangrong Wang,Jun Chen,Jianjun Sun,Yongjia Ji

doi:10.3389/fmicb.2018.03352

Abstract

Gut microbiota dysbiosis, which has been linked to many neurological diseases, is common in HIV infection. However, its role in the pathogenesis of neurocognitive impairment is still not established. In this study, a total of 85 HIV infected subjects, naïve to antiretroviral therapy, were classified into two groups—those with HIV-associated neurological diseases (HAND) and those without, using the Montreal Cognitive Assessment (MoCA) test. Fecal samples were collected from all subjects and microbiota were analyzed by 16S rRNA amplicon sequencing. Subjects with HAND were older (P < 0.001), with lower levels of education (P = 0.002), lower CD4 T-cell counts (P = 0.032), and greater heterosexual preference (P < 0.001), than those without HAND. Gut microbiota from subjects with HAND showed significantly lower α-diversity compared to gut microbiota from subjects without HAND (Shannon index, P = 0.003). To exclude confounding bias, 25 subjects from each group, with comparable age, gender, CD4 T-cell count, educational level and sexual preference were further analyzed. The two groups showed comparable α-diversity (for SOB index, Shannon index, Simpson index, ACE index, and Chao index, all with P-value > 0.05) and β-diversity (ANOSIM statistic = 0.010, P = 0.231). There were no significant differences in microbiota composition between the two groups after the correction for a false discovery rate. Consistently, microbiota from the two groups presented similar predictive functional profiles. Gut microbiota dysbiosis is not independently associated with neurocognitive impairment in people living with HIV.

Highlights

The prognosis for HIV-infected patients has improved significantly in the past two decades, as the incidence of various opportunistic infections decreased substantially due to combined antiretroviral therapy (Antiretroviral Therapy Cohort Collaboration, 2017)
Predictive functional profiling using the Kyoto encyclopedia of genes and genomes (KEGG) pathway showed that gut microbiota in the HIV-associated neurocognitive disorder (HAND) group were associated with higher abundances in the cellular processes compared to the non-HAND groups
We showed that gut microbiota dysbiosis is not independently associated with HAND

Summary

Introduction

The prognosis for HIV-infected patients has improved significantly in the past two decades, as the incidence of various opportunistic infections decreased substantially due to combined antiretroviral therapy (cART) (Antiretroviral Therapy Cohort Collaboration, 2017). The neurological symptoms caused by HIV infection are still not well-controlled (Fauci and Marston, 2015). In 2007, Gut Microbiota Dysbiosis and HAND these neurological symptoms were designated as HIV-associated neurocognitive disorder (HAND) (Antinori et al, 2007). HIV-associated dementia (HAD), the most severe form of HAND, has been reduced from 20 to 5% as a result of broader cART coverage, while other milder forms of HAND such as asymptomatic neurocognitive disorder (ANI) and mild neurocognitive disorder (MND) remain common (Gates et al, 2016; Saylor et al, 2016). PLWHA with HAND are less able to deal with complicated activities, resulting in poor medication compliance which leads to a shorter life expectancy and a lower quality of life (Berger and Brew, 2005; Antinori et al, 2007; Tozzi et al, 2007).

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Conclusion