In this analytical review, the authors present current views on the relationship between the persistence of HIV infection and the gut microbiome in people living with HIV (PLHIV). The study of this issue remains highly relevant for various reasons, because HIV-associated dysbiosis may underlie chronic diseases that persist and progress throughout the entire period of HIV infection, despite the control of viral load achieved with antiretroviral therapy (ART). The identification of close pathogenetic links between intestinal bacteria and HIV-associated diseases contributes to the development of new treatments aimed at changing the intestinal microbiome. It has been demonstrated that the gut microbiome has the potential to influence HIV disease at every stage of the viral life cycle, from infection through AIDS, opening the door for therapeutic interventions targeting the gut microbiome at each of these stages. Modern therapeutic strategies, including ART and agents aimed to normalizing the gut microbiome and reducing systemic chronic inflammation, may influence the existence of the HIV reservoir and thereby provide a cure for HIV infection.