Reviews in medical virologySep 16, 2026

Changes in Gut Bacteria in People with HIV Linked to Immune Problems and Treatment Options

Gut-Brain Axis Weekly Brief ↗PubMed ↗DOI ↗

Updated Sep 17, 2026

Abstract

The review synthesizes evidence on the interaction between HIV and gut microbiota, emphasizing its importance in managing HIV infection.

HIV infection is associated with gut microbiota disruption and mucosal immune dysfunction, potentially leading to chronic inflammation.
Different classes of antiretroviral therapy (ART) may have varying effects on the composition of the intestinal microbiome.
The microbiota-gut-brain axis could play a role in the development of HIV-associated neurocognitive disorders (HAND).
Microbiota-targeted interventions, such as probiotics and dietary strategies, show potential for therapeutic application in people living with HIV.
The review identifies critical knowledge gaps and suggests research priorities for future microbiota-informed strategies in HIV management.

Simplified

The interaction between the human immunodeficiency virus (HIV) and the gut microbiota is attracting growing interest due to its potential role in the progression of infection and the development of comorbidities. This review provides a comprehensive and critically appraised synthesis of current evidence on the bidirectional relationship between HIV infection and gut microbiota disruption, structured around four central themes: the mechanistic basis of HIV-associated gut dysbiosis and mucosal immune dysfunction and its link to chronic inflammation; the effects of different antiretroviral therapy (ART) classes on the intestinal ecosystem; the emerging role of the microbiota-gut-brain axis in the pathogenesis of HIV-associated neurocognitive disorders (HAND); and the therapeutic potential of microbiota-targeted interventions, including probiotics, prebiotics, synbiotics, faecal microbiota transplantation (FMT), and dietary strategies in people living with HIV (PLWH). By synthesising the current mechanistic, clinical, and translational evidence, this review aims to delineate the critical knowledge gaps and define the research priorities that will drive the next generation of microbiota-informed strategies for improving long-term outcomes in PLWH. This summary highlights the importance of considering the gut microbiota as a key player in the overall management of HIV infection.

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Changes in Gut Bacteria in People with HIV Linked to Immune Problems and Treatment Options

Abstract

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