Gut Microbiota Dysbiotic Pattern and Its Associated Factors in a Cameroonian Cohort with and without HIV Infection

Abstract

Aims: To compare the gut microbiota dysbiotic pattern between the HIV-negative individual and HIV-positive patients with /or without first-line ARV and cotrimoxazole prophylaxis treatment through culture-dependent technique. And additionally to access the associations of gut microbiota at the genus level with sociodemographic and clinical factors. Study Design:  This was a cross-sectional study. Place and Duration of Study: Participants were selected from the South West region at the Buea Regional Hospital UPEC unit. The study spanned from August 2018 to April 2019. Methodology: We included 160 participants. Fecal and blood samples were collected from HIV-negative individuals (n=40), HIV-positive treatment naïve (n=40), HIV-positive + ARV (n=40) and HIV-positive + ARV + Cotrimoxazole prophylaxis (n=40). A self-structured questionnaire was administered to collect sociodemographic data. The stool samples were plated using three non-selective and ten selective media and colonies were identified using biochemical characterization methods. The CD4+ T cells (cells/mm3) count were evaluated with BD FACSCount System. Data were analysed using SPSS version 21. Categorical variables were analysed using the Chi-square test and multinomial Logistic regression analysis was used to verify associations between variables. Results: The HIV-treatment naïve individual fecal samples showed a significantly increased growth occurrence for Candida (P < .001) and Fusobacteria (P < .001); and a decreased growth occurrence for Enterobacteriaceae family (P < .001), Staphylococcus (P < .001), Lactobacillus (P < .001) and Bifidobacteria (P < .001) compared to those of HIV-negative individuals. HIV-positive individuals on ARV and Cotrimoxazole had their stool samples showing a significantly decreased growth occurrence for Escherichia (P = .014), Salmonella (P = .002) and Staphylococcus (P = .04) compared to HIV-positive patients on ARV only. Increased growth occurrence of particular gut microbiota among participants was more likely associated with age, origin, residence community, occupation, drink, diet, and CD4+T cell count. Conclusion: Our findings uncover dysbiotic changes at the genus level in the gut through culture-dependent technique in an adult Cameroonian population. The study enriched our insight on the effect of ART and cotrimoxazole prophylaxis in promoting dysbiosis towards a positive outcome by lowering pathobionts levels. Additionally, we revealed associations of sociodemographic and clinical factors with the occurrence of particular gut microbiota, thus reiterating the need for more in-depth and longitudinal studies to corroborate our findings.