The lung microbiome plays a significant role in normal lung function and disease.
Because microbial colonization is likely influenced by immunodeficiency, one would
speculate that infection with human immunodeficiency virus (HIV) alters the lung microbiome.
Furthermore, how this alteration might impact pulmonary complications now seen in
HIV-infected patients on antiretroviral therapy (ART), which has shifted from opportunistic
infections to diseases associated with chronic inflammation, is not known. There have
been limited publications on the lung microbiome in HIV infection, many of them emanating
from the Lung HIV Microbiome Project. Current evidence suggests that the lung microbiome
in healthy HIV-infected individuals with preserved CD4 counts is similar to uninfected
individuals. However, in individuals with more advanced disease, there is an altered
alveolar microbiome characterized by a loss of richness and evenness (alpha diversity)
within individuals. Furthermore, as a group the taxa making up the HIV-infected and
uninfected lung microbiome are different (differences in beta diversity), and the
HIV-infected population is more spread out (greater dispersion) than the uninfected
population. These differences decline with ART, but even after effective therapy the
alveolar microbiome in HIV-infected individuals contains increased amounts of signature
bacteria, some of which have previously been associated with chronic lung inflammation.
Furthermore, more recent investigations into the lung virome in HIV infection suggest
that perturbations in lung viral communities also exist in HIV infection, and that
these too are associated with evidence of lung inflammation. Thus, it is likely both
microbiome and virome alterations in HIV infection contribute to lung inflammation
in these individuals, which has important implications on the changing spectrum of
pulmonary complications in patients living with HIV.
Abbreviations:
NIH (National Institutes of Health), HIV (human immunodeficiency virus), LHMP (Lung Human Microbiome Project), ART (antiretroviral therapy), AM (alveolar macrophage), BAL (bronchoalveolar lavage), COPD (chronic obstructive lung disease), OTU (operational taxonomic unit), DNA (deoxyribonucleic acid), RNA (ribonucleic acid), PBMCs (peripheral blood mononuclear cells)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 18, 2016
Accepted:
July 7,
2016
Received in revised form:
July 6,
2016
Received:
April 25,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
