CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

214 ACUTE HIV INFECTION AND HUMAN GUT MICROBIOME BEFORE AND AFTER ANTIRETROVIRAL THERAPY Ornella Sortino 1 , Nittaya Phanuphak 2 , Nitiya Chomchey 3 , Yasmine Belkaid 4 , Jacquice Davis 4 , Mariam Quinones 4 , Suteeraporn Pinyakorn 5 , Jintanat Ananworanich 2 , Jason Brenchley 4 , Irini Sereti 4 1 Leidos Biomed Rsr, Inc, Frederick, MD, USA, 2 SEARCH, Thai Red Cross AIDS Rsr Cntre, Bangkok, Thailand, 3 SEARCH, Bangkok, Thailand, 4 NIAID, Bethesda, MD, USA, 5 Henry M. Jackson Fndn for the Advancement of Military Med, Bethesda, MD, USA Background: The etiology of persistent immune activation in chronic HIV infection is incompletely understood and is probably multifactorial encompassing residual HIV replication, co-infections, mucosal alterations and deficient immune restoration. The intestinal gut microbiota could act as an integral driver of pathologic inflammation that persists even during the administration of antiretroviral therapy (ART). Methods: Anal swab samples were collected from 26 HIV- and 59 HIV+ Thai subjects with acute HIV infection (Fiebig stages I-IV) at baseline and 6 months after ART (2NRTI+Efavirenz). Total DNA was extracted from anal swabs. The V4 variable region of the 16S rRNA gene was amplified. Illumina paired-end was performed on the MiSeq platformwith MiSeq Control Software. The association of inflammatory markers with any taxa was assessed using Spearman’s correlation test. Results: Changes were found in the gut bacterial communities between baseline and 6 months post-ART: an increase in Fusobacteria eg. Fusobacterium (9% vs 30%), Proteobacteria eg. Campylobacter (12% vs 16%) and Tenericutes eg. Mycoplasma (0.9% vs 4.5%). Moreover, a decrease in Bacteroidetes eg. Prevotella (58% vs 31.5%) and Firmicutes eg. Lactobacillus (20% vs 17%) was documented (p<0.05 for both). Comparisons between HIV+ post-ART and HIV- showed a higher proportion of Fusobacteria in HIV+ (30% vs 10%). At 6 months of ART, persons treated at Fiebig (F) stages III-IV had a higher proportion of Proteobacteria (18% vs 7%, P<0.05), a higher percentage of Fusobacteria (9% vs 4.5%) and a lower proportion of Bacteroidetes (37% vs 49%) compared to those treated at FI-II. At baseline, Bacteroidetes and Firmicutes proportions negatively correlated with levels of C-Reactive Protein (CRP) (r=-0.40, p=0.02) and sCD14 (r=-0.36, p=0.03) respectively. The increase in Fusobacteria after ART positively correlated with CRP (r=0.37, p=0.04) and sCD14 levels post ART (r=0.56, p=0.01) while the percentage of Firmicutes was still negatively associated with sCD14 levels post ART (r=-0.4 p=0.03). Conclusion: Changes in the composition of the GI tract microbiome can be observed even in persons treated with ART during acute HIV infection with decreases in Bacteroides and Firmicutes. The association of specific taxa with markers of microbial translocation and systemic inflammation warrants further investigation of the potential role of microbiome alterations in HIV-associated inflammation.

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CROI 2017