Rectal Microbiome Alterations Associated With Oral Human Immunodeficiency Virus Pre-Exposure Prophylaxis
Rectal Microbiome Alterations Associated With Oral Human Immunodeficiency Virus Pre-Exposure Prophylaxis
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DOI：
10.1093/ofid/ofz463
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发表时间：
2019-11-01
影响因子：
4.2
通讯作者：
Aldrovandi, Grace M.
中科院分区：
文献类型：
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作者：
Fulcher, Jennifer A.;Li, Fan;Aldrovandi, Grace M.
背景每日口服替诺福韦（TFV）富马酸二异丙酯/恩曲他滨（TDF/FTC）用于人类免疫缺陷病毒（HIV）暴露前预防（PrEP）对HIV预防非常有效，但长期效果尚未完全了解。我们调查了PrEP对男性同性恋人群（MSM）直肠微生物组的影响。该横断面分析包括使用倾向评分匹配从正在进行的队列中选择的接受PrEP（n = 37）或未接受PrEP（n = 37）的HIV阴性MSM。直肠拭子用于使用16 S核糖体核糖核酸基因测序检查微生物组组成，并检查PrEP使用与微生物群丰度之间的关联。头发标本被用来量化TFV和FTC暴露在过去6周的一个子集的参与者（n = 15）。暴露前预防使用与链球菌丰度显著增加相关（校正P = 0.015）。使用最小绝对收缩和选择算子（LASSO）回归确定了类似的关联，证实了链球菌的增加，也显示了Mitsuokella，Fusobacterium的增加和Escherichia/Shigella的减少。梭杆菌的增加与TFV的增加显著相关。与匹配良好的对照相比，口服TDF/FTC用于PrEP与直肠微生物群变化相关，特别是链球菌和梭杆菌丰度增加。这项研究强调了未来调查微生物组变化对艾滋病毒易感性和PrEP有效性的作用的必要性。
Background. Oral daily tenofovir (TFV) disoproxil fumarate/emtricitabine (TDF/FTC) for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is highly effective for HIVprevention, yet long-term effects are not fully understood. We investigated the effects of PrEP on the rectal microbiome in a cohort of men who have sex with men (MSM).Methods. This cross-sectional analysis included HIV-negative MSM either on PrEP (n = 37) or not (n = 37) selected from an ongoing cohort using propensity score matching. Rectal swabs were used to examine microbiome composition using 16S ribosomal ribonucleic acid gene sequencing, and associations between PrEP use and microbiota abundance were examined. Hair specimens were used to quantify TFV and FTC exposure over the past 6 weeks on a subset of participants (n = 15).Results. Pre-exposure prophylaxis use was associated with a significant increase in Streptococcus abundance (adjusted P =.015). Similar associations were identified using least absolute shrinkage and selection operator (LASSO) regression, confirming the increase in Streptococcus and also showing increased Mitsuokella, Fusobacterium, and decreased Escherichia/Shigella. Increased Fusobacterium was significantly associated with increasing TFV exposure.Conclusions. Oral TDF/FTC for PrEP is associated with rectal microbiome changes compared to well matched controls, specifically increased Streptococcus and Fusobacterium abundance. This study highlights the need for future investigations of the role of microbiome changes on HIV susceptibility and effectiveness of PrEP.