A1 Journal article (refereed)
Gut microbiota alterations after switching from a protease inhibitor or efavirenz to raltegravir in a randomized, controlled study (2023)


Hanttu, A. M., Pekkala, S., Satokari, R., Hartikainen, A. K., Arkkila, P., Pietiläinen, K. H., & Sutinen, J. P. (2023). Gut microbiota alterations after switching from a protease inhibitor or efavirenz to raltegravir in a randomized, controlled study. AIDS, 37(2), 323-332. https://doi.org/10.1097/QAD.0000000000003419


JYU authors or editors


Publication details

All authors or editorsHanttu, Anna M.; Pekkala, Satu; Satokari, Reetta; Hartikainen, Anna K.; Arkkila, Perttu; Pietiläinen, Kirsi H.; Sutinen, Jussi P.

Journal or seriesAIDS

ISSN0269-9370

eISSN1473-5571

Publication year2023

Volume37

Issue number2

Pages range323-332

PublisherLippincott Williams & Wilkins

Publication countryUnited Kingdom

Publication languageEnglish

DOIhttps://doi.org/10.1097/QAD.0000000000003419

Publication open accessNot open

Publication channel open access

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/88766


Abstract

Objective:
To study gut microbiota before and 24 weeks after a single antiretroviral agent switch.

Design:
HIV-positive patients with efavirenz (EFV) or a protease inhibitor (PI)-based antiretroviral therapy (ART) were randomized to switch EFV or PI to raltegravir (RAL group, n = 19) or to continue unchanged ART (EFV/PI group, n = 22). Age and weight-matched HIV-negative participants (n = 10) were included for comparison.

Methods:
Microbiota was analyzed using 16S rRNA sequencing. Serum intestinal fatty acid-binding protein (I-FABP) and serum lipopolysaccharide-binding protein (LBP) were measured as gut permeability markers. Three-day food diaries were collected.

Results:
At week 24, microbiota diversity (Chao1 index) was higher in RAL than the EFV/PI group (P = 0.014), and RAL group did not differ from HIV-negative participants. In subgroup analysis switching from EFV (P = 0.043), but not from a PI to RAL increased Chao1. At week 24, RAL and EFV/PI group differed in the relative abundance of Prevotella 9 (higher in RAL, P = 0.01), Phascolarctobacterium and Bacteroides (lower in RAL, P = 0.01 and P = 0.03). Dietary intakes did not change during the study and do not explain microbiota differences. Also, I-FABP and LBP remained unchanged.

Conclusion:
Here we demonstrate that a single ART agent switch caused microbiota alterations, most importantly, an increase in diversity with EFV to RAL switch. Previously, we reported weight gain, yet reduced inflammation in this cohort. The observed microbiota differences between RAL and EFV/PI groups may be associated with reduced inflammation and/or increase in weight. Further studies are needed to evaluate inflammatory and metabolic capacity of microbiota with ART switches.


KeywordsHIV infectionpharmacotherapygastrointestinal microbiota

Free keywordsefavirenz; gut microbiota; HIV; protease inhibitor; raltegravir


Contributing organizations


Ministry reportingYes

VIRTA submission year2023

JUFO rating1


Last updated on 2024-02-07 at 23:27