Microbiota in the oral cavity of school-age children with HIV who started antiretroviral therapy at young ages in South Africa

Author:

Kuhn Louise1,Wang Tian2,Li Fan3,Strehlau Renate4,Tobin Nicole H.3,Violari Avy5,Brooker Sarah3,Patel Faeezah6,Liberty Afaaf5,Shiau Stephanie7,Arpadi Stephen M.1,Wadhwa Sunil8,Yin Michael T.9,Wang Shuang2,Tiemessen Caroline T.10,Aldrovandi Grace M.3

Affiliation:

1. Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health

2. Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York

3. Department of Pediatrics, University of California Los Angeles, Los Angeles, California, USA

4. VIDA Nkanyezi Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health

5. Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital

6. Wits RHI, Shandukani Research Centre, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

7. Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey

8. College of Dental Medicine

9. Division of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York

10. National Institutes for Communicable Diseases, and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: Infancy is an important developmental period when the microbiome is shaped. We hypothesized that earlier antiretroviral therapy (ART) initiation would attenuate HIV effects on microbiota in the mouth. Methods: Oral swabs were collected from 477 children with HIV (CWH) and 123 children without (controls) at two sites in Johannesburg, South Africa. CWH had started ART less than 3 years of age; 63% less than 6 months of age. Most were well controlled on ART at median age 11 years when the swab was collected. Controls were age-matched and recruited from the same communities. Sequencing of V4 amplicon of 16S rRNA was done. Differences in microbial diversity and relative abundances of taxa were compared between the groups. Results: CWH had lower alpha diversity than controls. Genus-level abundances of Granulicatella, Streptococcus, and Gemella were greater and Neisseria and Haemophilus less abundant among CWH than controls. Associations were stronger among boys. Associations were not attenuated with earlier ART initiation. Shifts in genus-level taxa abundances in CWH relative to controls were most marked in children on lopinavir/ritonavir regimens, with fewer shifts seen if on efavirenz ART regimens. Conclusion: A distinct profile of less diverse oral bacterial taxa was observed in school-aged CWH on ART compared with uninfected controls suggesting modulation of microbiota in the mouth by HIV and/or its treatments. Earlier ART initiation was not associated with microbiota profile. Proximal factors, including current ART regimen, were associated with contemporaneous profile of oral microbiota and may have masked associations with distal factors such as age at ART initiation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Infectious Diseases,Immunology,Immunology and Allergy

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