Population dynamics of Malassezia species on the skin of HIV-infected patients

Abstract

Malassezia species are lipid-dependent yeasts of the normal skin mycobiota in humans and some animals, which can cause skin infections. Yet, both the dynamic of Malassezia skin colonization and the associated fungal and bacterial skin microbiome remain unknown in HIV-infected patients. The purpose of this study was to compare Malassezia yeast community structure and associated microbiome on the healthy skin of HIV-infected patients and healthy controls. A total of 23 HIV-infected patients and 10 healthy controls were included and followed-up for a maximum of 5 visits over 10 to 17 months. At each visit, chest, face, nasolabial fold, and scalp skin samples were subjected to both culture and MALDI-TOF MS identification, and ITS/16S metabarcoding. The participants were categorized according to their Malassezia colony forming unit (CFU) abundance. Malassezia were cultured from each participant at each visit. HIV-infected patients were highly colonized on all visits with CFU > 100. M. sympodialis and M. globosa were the most dominant species overall. M. furfur and M. dermatis were more prevalent in HIV-infected than in healthy participants. M. sympodialis prevalence was stable at each sampling sites over time. M. furfur prevalence was stable and more abundant over time on HIV-infected patients’ chest. Although not statistically significant, the metagenomic analysis showed a higher fungal and bacterial diversity and an increased abundance of Cladosporium halotolerans and Streptococcus in HIV-infected patients than in controls. Our data showed a high skin colonization of Malassezia yeasts as well as a dysbiosis of both fungal and bacterial communities in HIV-infected patients.