Association between gut microbiota in HIV-infected patients and immune reconstitution following antiretroviral therapy (ART).

Background: This study aims to examine the potential link between incomplete immune reconstitution following ART treatment and gut microbiota dysbiosis.

Methods: We collected clinical data and fecal samples from 50 HIV patients undergoing ART and 30 untreated patients. Based on the observed immune function reconstruction, we further categorized the ART(+) group into a responder group (n = 30) and a non-responder group (n = 20). The gut microbiota composition differences were assessed using Alpha diversity and Beta diversity analysis, while differential genera were identified through linear discriminant analysis effect size (LEfSe). Subsequently, functional disparities in the gut microbiota were investigated using PICRUSt2 and metagenomeSeq software.

Results: The results of Alpha diversity and Beta diversity revealed significant differences in the composition of gut microbiota among the three groups. Differential genus analysis identified Morganella as an exclusive genus present only in the Non-responder group, exhibiting a significantly higher relative abundance. Correlation analysis demonstrated a positive association between Morganella and LDL levels. The CAZY analysis revealed that glycosyltransferase 25 (GT25) was significantly expressed in the Non-responder group, whereas it was either undetectable or exhibited extremely low expression levels in both the Responder group and the ART(-) group. Importantly, the correlation analysis indicated a positive association between Morganella and GT25 secretion.

Conclusions: The ecological imbalance of Morganella might be associated with incomplete immune reconstitution following ART, potentially mediated by GT25 secretions. Consequently, Morganella could serve as a promising biomarker for predicting incomplete immune reconstitution in AIDS patients undergoing ART.