Altered intestinal microbiota in successfully cART-treated HIV-infected males with high-risk HPV genotypes and anal HPV-related cytological abnormalities

HIV infection facilitates the persistence of mucosal HPV and increases the risk of cytological abnormalities trough a mechanism still not fully understood. Recently, a role of altered microbiota
has been described. Thus, we decided to explore the possible association(s) between HPV persistence, gut microbiota composition, microbial translocation (MT) and immune activation/inflammation in suppressive cART-treated HIV+ males within the anal district.
We enrolled 30 HIV+ cART-treated males: 6/30 with normal cytology and low-risk HPV genotypes (nHPV_low), 6/30 with normal cytology and high-risk HPV genotypes (nHPV_high) and 18/30 with HPV-related cytological abnormalities (ASUS, LSIL, HSIL) and high-risk HPV genotypes (aHPV_high). While richness and evenness indexes were similar between groups, relative abundance and β-diversity analyses revealed differences in stool microbiota composition. In particular, nHPV_low featured lower relative abundance of Prevotellaceae and Veillonellaceae, but higher Lachnospiraceae, Bacteroidaceae and Rikenellaceae, as compared to both nHPV_high and aHPV_high. These observations were also confirmed by LEfSe analysis. No differences in MT and immune activation/inflammation markers, according to HPV-related cytological abnormalities and HPV genotypes were found.
In conclusion, in HIV+ males on suppressive cART, components of the fecal microbiota associates with anal HPV-related cytological abnormalities and HPV high-risk genotypes, supporting the role of gut microbiota in HPV persistence and pathogenesis.

Esther Merlini
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