Microbiota-Meditated Immunity Abnormalities Facilitate Hepatitis B Virus Co-Infection in People Living With HIV: A Review

Abstract

Hepatitis B virus (HBV) co-infection is fairly common in people living with HIV (PLWH) and affects millions of people worldwide. Identical transmission routes and HIV-induced immune suppression have been assumed to be the main factors contributing to this phenomenon. Moreover, convergent evidence has shown that people co-infected with HIV and HBV are more likely to have long-term serious medical problems, suffer more from liver-related diseases, and have higher mortality rates, compared to individuals infected exclusively by either HIV or HBV. However, the precise mechanisms underlying the comorbid infection of HIV and HBV have not been fully elucidated. In recent times, the human gastrointestinal microbiome is progressively being recognized as playing a pivotal role in modulating immune function, and is likely to also contribute significantly to critical processes involving systemic inflammation. Both antiretroviral therapy (ART)-naïve HIV-infected subjects and ART-treated individuals are now known to be characterized by having gut microbiomic dysbiosis, which is associated with a damaged intestinal barrier, impaired mucosal immunological functioning, increased microbial translocation, and long-term immune activation. Altered microbiota-related products in PLWH, such as lipopolysaccharide (LPS) and short-chain fatty acids (SCFA), have been associated with the development of leaky gut syndrome, favoring microbial translocation, which in turn has been associated with a chronically activated underlying host immune response and hence the facilitated pathogenesis of HBV infection. Herein, we critically review the interplay among gut microbiota, immunity, and HIV and HBV infection, thus laying down the groundwork with respect to the future development of effective strategies to efficiently restore normally diversified gut microbiota in PLWH with a dysregulated gut microbiome, and thus potentially reduce the prevalence of HBV infection in this population.

Coronary heart disease in patients with human immunodeficiency virus infection

“…Возникающая в результате иммунного ответа системная воспалительная реакция связана с клиническим прогрессированием ВИЧ и возникновением сопутствующих заболеваний, не связанных с иммунодефицитом [21]. У пациентов, получающих АРТ, состав микробиома кишечника изменяется по сравнению с таковым у неинфицированных лиц, что предполагает влияние провоспалительного компонента со стороны бактериальной флоры желудочно-кишечного тракта независимо от эффективности АРТ и уровня вирусной нагрузки [22].…”

Gut Microbiome (Bacteria, Fungi, and Viruses) and HIV Infection: Revealing Novel Treatment Strategies

“…Analyses of gut bacteria in cross-sectional cohorts of HIV-infected and uninfected individuals have shown the changes in the bacterial microbiota of infected people. [26,27] Edda et al suggested that PLH had distinct gut microbiota. Generally, a decrease in commensal species and a gain in pathogenic taxa can be observed in PLH (Table 1).…”

“…[13,28] According to relevant research data, alterations of gut microbiota in PLH mainly manifest as changes in microbial diversity, a reduction in symbiotic beneficial bacteria, and an increase in potentially pathogenic bacteria. [26] However, due to the particularity of HIV, there are some differences in gut bacteria among different population structures (Table 1), which are mainly associated with the different sexual preferences, the duration and type of ART, and the status of immune response. [26] Also, some findings have indicated that maternal HIV status has a profound impact on the infant gut microbiota.…”

“…[ 26 ] However, due to the particularity of HIV, there are some differences in gut bacteria among different population structures (Table 1), which are mainly associated with the different sexual preferences, the duration and type of ART, and the status of immune response. [ 26 ] Also, some findings have indicated that maternal HIV status has a profound impact on the infant gut microbiota. [ 29 ] Thus, studies on gut bacteria in HIV are mainly conducted based on different populations.…”

HIV Infection Predisposes to Increased Chances of HBV Infection: Current Understanding of the Mechanisms Favoring HBV Infection at Each Clinical Stage of HIV Infection

“…An HIV-positive individual displaying an HIV-associated gut dysbiosis profile can, thus, readily develop HBV infection, as HIV-associated microbial translocation favors hepatocyte injury. Our group has recently published an extensive review discussing mechanisms whereby gastrointestinal microbiome dysbiosis and a "leaky" gut in PLWH increases susceptibility to HBV infection (132).…”