A gut microbiome signature for HIV and non-alcoholic fatty liver disease

The gut microbiome has been widely studied in the context of health and disease, andis increasingly being recognized as a key factor in the pathogenesis of non-alcoholicfatty liver disease (NAFLD). Studies in the general population suggest that NAFLD isassociated with altered gut microbial composition, however, little is known about its rolein the development of NAFLD in people with HIV (PLWH). This study explored the roleof the gut microbiome in the development of non-alcoholic fatty liver disease in peoplewith HIV. We included 30 HIV+NAFLD+, 8 HIV+NAFLD- and 20 HIV-NAFLD+participants, and characterized the gut microbiota composition in all groups. Alphadiversity was higher among NAFLD+ participants, indicating that both NAFDL and HIVstatus had additive effects on alpha diversity. Beta diversity analysis on Bray-Curtisdistances showed distinct clustering in NAFLD-, with NAFLD+ participants overlappingregardless of HIV status. We found that NAFLD is associated with increasedhomogeneity across individuals, in contrast to that observed in the HIV+NAFDL- group.We then used the LEfSe biomarker discovery tool to investigate which generadetermined baseline differences in microbial communities between groups. The mostabundant genera in participants with NAFLD-, and the most likely genera to explain thedifferences with NAFLD+, were Prevotella, Bacteroides, Dialister, Acidaminococcos,Alloprevotella, and Catenibacterium. In contrast, the most enriched genera in NAFLD+were Ruminococcus, Streptococcus. These results suggest that the gut microbiome ofHIV-infected individuals is significantly different than that of HIV-uninfected individuals,and that certain microbial taxa are associated with NAFLD. This study provides newinsight into the role of the gut microbiome in HIV and NAFLD and may haveimplications for the diagnosis, treatment, and prevention of these diseases.