Dataset Information

An exploration of Prevotella-rich microbiomes in HIV and men who have sex with men.

ABSTRACT: BACKGROUND:Gut microbiome characteristics associated with HIV infection are of intense research interest but a deep understanding has been challenged by confounding factors across studied populations. Notably, a Prevotella-rich microbiome described in HIV-infected populations is now understood to be common in men who have sex with men (MSM) regardless of HIV status, but driving factors and potential health implications are unknown. RESULTS:Here, we further define the MSM-associated gut microbiome and describe compositional differences between the fecal microbiomes of Prevotella-rich MSM and non-MSM that may underlie observed pro-inflammatory properties. Furthermore, we show relatively subtle gut microbiome changes in HIV infection in MSM and women that include an increase in potential pathogens that is ameliorated with antiretroviral therapy (ART). Lastly, using a longitudinal cohort, we describe microbiome changes that happen after ART initiation. CONCLUSIONS:This study provides an in-depth characterization of microbiome differences that occur in a US population infected with HIV and demonstrates the degree to which these differences may be driven by lifestyle factors, ART, and HIV infection itself. Understanding microbiome compositions that occur with sexual behaviors that are high risk for acquiring HIV and untreated and ART-treated HIV infection will guide the investigation of immune and metabolic functional implications to ultimately target the microbiome therapeutically.

SUBMITTER: Armstrong AJS

PROVIDER: S-EPMC6219090 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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An exploration of Prevotella-rich microbiomes in HIV and men who have sex with men.

Armstrong Abigail J S AJS Shaffer Michael M Nusbacher Nichole M NM Griesmer Christine C Fiorillo Suzanne S Schneider Jennifer M JM Preston Neff C C Li Sam X SX Fontenot Andrew P AP Campbell Thomas T Palmer Brent E BE Lozupone Catherine A CA

Microbiome 20181105 1

<h4>Background</h4>Gut microbiome characteristics associated with HIV infection are of intense research interest but a deep understanding has been challenged by confounding factors across studied populations. Notably, a Prevotella-rich microbiome described in HIV-infected populations is now understood to be common in men who have sex with men (MSM) regardless of HIV status, but driving factors and potential health implications are unknown.<h4>Results</h4>Here, we further define the MSM-associate ...[more]

PMID: 30396369

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Project description:BackgroundAlthough efficacy is unknown, many men who have sex with men (MSM) attempt to reduce HIV risk by adapting condom use, partner selection, or sexual position to the partner's HIV serostatus. We assessed the association of seroadaptive practices with HIV acquisition.Methodology/principal findingsWe pooled data on North American MSM from four longitudinal HIV-prevention studies. Sexual behaviors reported during each six-month interval were assigned sequentially to one of six mutually exclusive risk categories: (1) no unprotected anal intercourse (UAI), (2) having a single negative partner, (3) being an exclusive top (only insertive anal sex), (4) serosorting (multiple partners, all HIV negative), (5) seropositioning (only insertive anal sex with potentially discordant partners), and (6) UAI with no seroadaptive practices. HIV antibody testing was conducted at the end of each interval. We used Cox models to evaluate the independent association of each category with HIV acquisition, controlling for number of partners, age, race, drug use, and intervention assignment. 12,277 participants contributed to 60,162 six-month intervals with 663 HIV seroconversions. No UAI was reported in 47.4% of intervals, UAI with some seroadaptive practices in 31.8%, and UAI with no seroadaptive practices in 20.4%. All seroadaptive practices were associated with a lower risk, compared to UAI with no seroadaptive practices. However, compared to no UAI, serosorting carried twice the risk (HR?=?2.03, 95%CI:1.51-2.73), whereas seropositioning was similar in risk (HR?=?0.85, 95%CI:0.50-1.44), and UAI with a single negative partner and as an exclusive top were both associated with a lower risk (HR?=?0.56, 95%CI:0.32-0.96 and HR?=?0.55, 95%CI:0.36-0.84, respectively).Conclusions/significanceSeroadaptive practices appear protective when compared with UAI with no seroadaptive practices, but serosorting appears to be twice as risky as no UAI. Condom use and limiting number of partners should be advocated as first-line prevention strategies, but seroadaptive practices may be considered harm-reduction for men at greatest risk.

Project description:BackgroundPrevious studies estimating the fraction of transmissions from persons with primary HIV have not focused on the effects of switching sex role in male homosexual populations. Such behavioral fluctuations can increase the contribution of primary HIV in the overall population.MethodsWe modeled HIV transmission with 8 compartments defined by 4 behavioral groups, with different anal-insertive and anal-receptive combinations, and 2 stages of infection. We explored the effects of fluctuating behavioral categories on endemic prevalence and the fraction of transmissions from primary HIV. We varied transition rates to develop the theory on how behavioral fluctuation affects infection patterns, and we used the transition rates in a Netherlands cohort to assess overall effects in a real setting.ResultsThe dynamics of change in behavior-group status over time observed in the Netherlands cohort amplifies the prevalence of infection and the fraction of transmissions from primary HIV, resulting in the highest proportions of transmissions being from people with primary HIV. Fluctuation between dual- or receptive-role periods and no-anal-sex periods mainly determines this amplification. In terms of the total transmissions, the dual-role risk group is dominant. Fluctuation between insertive and receptive roles decreases the fraction of transmissions from primary HIV, but such fluctuation is infrequently observed.ConclusionThe fraction of transmissions from primary HIV is considerably raised by fluctuations in insertive and receptive anal sex behaviors. This increase occurs even when primary HIV or later infection status does not influence risk behavior. Thus, it is not simply biology but also behavior patterns and social contexts that determine the fraction of transmissions from primary HIV. Moreover, each primary HIV transmission has a larger population effect than each later infection transmission because the men to whom one transmits from primary HIV carry on more chains of transmissions than the men to whom one transmits later in infection. Reducing transmissions from primary HIV should be a primary focus of HIV control efforts.

Dataset Information

An exploration of Prevotella-rich microbiomes in HIV and men who have sex with men.

Publications

An exploration of Prevotella-rich microbiomes in HIV and men who have sex with men.

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