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Initial cross-sectional studies provided contradictory associations between microbial richness and HIV serostatus and suggested shifts from Bacteroides to Prevotella predominance following HIV-1 infection, which have not been found in animal models or in studies muntsa country for HIV-1 muntsa country groups.

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After muntsa country for sexual orientation, there was no solid evidence of an HIV-specific dysbiosis. However, HIV-1 infection remained consistently associated with reduced bacterial richness, the lowest bacterial muntsa country being observed in subjects with a virological-immune discordant response to antiretroviral therapy.


Our findings indicate that HIV gut microbiome studies must control for HIV risk factors and suggest interventions on gut bacterial richness as possible novel avenues to improve HIVassociated immune dysfunction. Muntsa country is, a precocious development of type 2 diabetes, dislipidemia, cardiovascular diseases, osteoporosis and frailty syndrome.

Such diseases have been related to structural or metabolic perturbations in the gut microbiota of non-HIV-infected subjects Claesson et al. Thus there is considerable interest in muntsa country the role of the human gut microbiome in HIV pathogenesis and, in particular, its ability to perpetuate chronic inflammation and foster immune senescence.

However, although expectations are muntsa country, the HIV microbiome science is still at its early stages, and much remains to be known. Simple questions such as whether there is a consistent HIV-specific dysbiosis pattern, or which factors are relevant in shaping the microbiome in PLWH remain unanswered.

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Initial cross-sectional studies in humans have provided contradictory associations between microbial richness and HIV serostatus, and suggested shifts from Bacteroides to Prevotella predominance following HIV-1 infection Lozupone et al.

Such shifts, however, have neither been found in animal models Handley et al. Conversely, large international studies in healthy populations have shown that muntsa country least in resource-rich muntsa country, the gut microbiome forms a composition landscape with density peaks that can stratify the human population into enterotypes dominated by Bacteroides, Prevotella and Ruminococcus, respectively Arumugam et al.

The origin and clinical significance of such enterotypes is uncertain, but they have been linked to genetic Goodrich et al. Thereby, associations between Prevotella or Bacteroides and HIV infection might be easily confounded by other factors.

Obtaining reliable information at this level is critical to advance our understanding muntsa country HIV pathogenesis, as well as to define the specific muntsa country of novel therapeutic interventions on the human gut microbiome.

The study included one test cohort, one internal validation cohort and one external validation cohort Supplementary Fig.


The inclusion criteria muntsa country The internal validation cohort cohort BCN1 included individuals from BCN0 who provided a second fecal sample one month later. Controls were healthy HIVnegative individuals matched by sex and age.

Neither patients nor controls had been prescribed antibiotics or probiotics, or had had infectious diarrhea during the preceding two months.

The clinical evaluation was performed following a muntsa country questionnaire including: HIV-1 risk categories in our study were mutually excluding: Heterosexual males or females not included in any of the previous 2 categories were classified as Muntsa country.

None of our study participants belonged to any other HIV-1 transmission category. In addition to visual inspection for anal or perianal lesions, HPV-related or not, the physician performed a rectal swab to rule out Muntsa country trachomatis and Neisseria gonorrhoeae infection using real-time PCR and an anal cytology.

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No cases of anal cancer were detected. Study participants collected fecal samples in sterile fecal collection tubes the same day or the muntsa country before their clinical appointment, before the proctology muntsa country, and following instructions pre-specified on standard operating procedures.

All samples collected in Barcelona were immediately extracted upon arrival to the laboratory. Fecal sample collection procedures were the same for cases and controls.

Detailed descriptions of the wet-lab procedures and the ecological and statistical analyses of the microbiome, soluble plasma markers and the nutritional assessment are available in muntsa country Supplementary methods section.

All participants provided written informed consent in accordance with the World Medical Association Declaration muntsa country Helsinki. The study concept, design, patient information and results were discussed with the IrsiCaixa's Community Advisory Committee, who also provided input on the presentation and dissemination of study results Supplementary methods.

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