Anal microbiota profiles in HIV-positive and HIV-negative MSM

• Published in: AIDS (London) Vol. 28; no. 5; pp. 753 - 760
• Main Authors: GUOQIN YU, FADROSH, Doug, BING MA, RAVEL, Jacques, GOEDERT, James J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 13.03.2014
• Subjects: Acquired Immunodeficiency Syndrome - pathology; Adonis; Adult; Aged; AIDS/HIV; Anal Canal - microbiology; Bacteria - classification; Bacteria - genetics; Biological and medical sciences; Biota; CD4 Lymphocyte Count; Cluster Analysis; Cohort Studies; DNA, Bacterial - chemistry; DNA, Bacterial - genetics; DNA, Ribosomal - chemistry; DNA, Ribosomal - genetics; Firmicutes; Homosexuality, Male; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Lentivirus; Male; Medical sciences; Middle Aged; Pneumoviridae; Retroviridae; RNA, Ribosomal, 16S - genetics; Sequence Analysis, DNA; Time Factors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Human; Immunopathology; risk factors; MSM; Retroviridae; sexual activities; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Anus; HIV; human microbiome; anal; Viral disease; Risk factor; Human immunodeficiency virus
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/qad.0000000000000154

Because differences in anal microbial populations (microbiota) could affect acquisition of HIV or other conditions, especially among MSM, we profiled the microbiota of the anal canal, assessed its stability, and investigated associations with diversity and composition. Microbiota profiles in anal swabs collected from 76 MSM (52 in 1989, swab-1; 66 1-5 years later, swab-2) were compared by HIV status (25 HIV-positive), T-cell subsets, and questionnaire data. Bacterial 16S rRNA genes were amplified, sequenced (Illumina MiSeq), and clustered into species-level operational taxonomic units (QIIME and Greengenes). Regression models and Wilcoxon tests were used for associations with alpha diversity (unique operational taxonomic units, Shannon's index). Composition was compared by Adonis (QIIME). Most anal bacteria were Firmicutes (mean 60.6%, range 21.1-91.1%) or Bacteroidetes (29.4%, 4.1-70.8%). Alpha diversity did not change between the two swabs (N = 42 pairs). In swab-2, HIV-positives had lower alpha diversity (P ≤ 0.04) and altered composition, with fewer Firmicutes and more Fusobacteria taxa (P ≤ 0.03), not completely attributable to very low CD4(+) cell count (median 232 cells/μl), prior AIDS clinical diagnosis (N = 17), or trimethoprim-sulfamethoxazole use (N = 6). Similar but weaker differences were observed in swab-1 (HIV-positive median 580 CD4(+) cells/μl; no trimethoprim-sulfamethoxazole). Associations with T-cell subsets, smoking, and sexual practices were null or inconsistent. The anal microbiota of MSM was relatively stable over 1-5 years. However, with uncontrolled, advanced HIV infection, the microbiota had altered composition and reduced diversity partially attributable to antibiotics. Investigations of microbial community associations with other immune perturbations and clinical abnormalities are needed.