ORIGINAL RESEARCH article
Front. Immunol.
Sec. Microbial Immunology
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1555441
This article is part of the Research TopicHIV and the Gut: Novel Insights into HIV Pathogenesis, Clinical Implications and Therapeutic ApproachesView all 3 articles
Microbiome profiling reveals gut bacterial species associated with rapid lung function decline in people with HIV
Provisionally accepted
Xiangning Bai1,2*
Sajan C Raju1
Andreas Dehlbaek Knudsen3Rebekka Faber Thudium3
Nicoline Arentoft3Marco Gelpi3
Safura-Luise Heidari3Ken M Kunisaki4
Karsten Kristiansen5
Johannes Espolin Roksund Hov1
Susanne Dam Nielsen3Marius Trøseid1- 1Oslo University Hospital, Oslo, Norway
- 2Department of Medicine, Huddinge, Karolinska Institutet (KI), Huddinge, Stockholm, Sweden
- 3Rigshospitalet, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark
- 4University of Minnesota, Minneapolis, Minnesota, United States
- 5University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark
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Background: People with HIV (PWH) have an increased risk of pulmonary comorbidities compared to people without HIV. The gut microbiome regulates host immunity and is altered in PWH. This study aims to determine potential associations between gut microbiome, lung function decline, and airflow limitation in PWH.Methods: PWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study with available lung function testing and microbiome data were included (n=385). The gut microbiome was characterized using shotgun metagenomic sequencing. Associations between gut microbiome, rapid lung function decline, and airflow limitation were analysed in multivariable logistic regressions adjusted for traditional and HIV-associated risk factors for lung disease. Results: Several bacterial species were significantly enriched in PWH with rapid lung function decline, including opportunistic pathogenic bacterial species Bacteroides coprophilus, Klebsiella michiganensis, and Clostridium perfringens. A gut microbial dysbiosis index based on compositional changes was associated with rapid lung function decline (adjusted odds ratio (aOR) 1.18, 95% confidence interval (CI) [1.11-1.27], p<0.001), and airflow limitation (aOR 1.16, 95% CI [1.04-1.29], p=0.007) in adjusted multivariable logistic regression analyses. Conclusion: Associations between the gut dysbiosis index and rapid lung function decline and airflow limitation suggest a potential role of certain gut bacterial species in the pathogenesis of pulmonary comorbidities in PWH.
Keywords: HIV, gut microbiome, Pulmonary comorbidity, lung function decline, Airflow limitation, Spirometry
Received: 04 Jan 2025; Accepted: 06 May 2025.
Copyright: © 2025 Bai, Raju, Dehlbaek Knudsen, Faber Thudium, Arentoft, Gelpi, Heidari, Kunisaki, Kristiansen, Roksund Hov, Nielsen and Trøseid. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangning Bai, Oslo University Hospital, Oslo, Norway
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