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. Author manuscript; available in PMC: 2017 Jun 1.
Published in final edited form as: Clin Pharmacol Ther. 2016 Apr 16;99(6):600–611. doi: 10.1002/cpt.363

Figure 3. Microbiome influence through all stages of HIV infection.

Figure 3

The microbiome has the potential to have an influence throughout the entire natural history of HIV disease. Transmission: Since HIV preferentially infects activated T cells, dysbiotic microbiomes that activate CD4+ T cells can enhance disease transmission at mucosal sites. Disease Progression: The translocation of gut microbes through the intestinal barrier is thought to drive immune activation and disease progression. Chronic Infection: The gut microbiome differs from that of HIV-negative controls in chronic infection, and the myriad of health effects that may result from this dysbiotic microbiome are not understood. AIDS: Even more dramatic gut microbiome differences from healthy controls may occur with AIDS. Diarrhea, malabsorption, wasting and opportunistic infections that originate in the gut are common. ART: The gut microbiome of HIV-infected individuals on ART still differs from that of healthy controls. The effects of this dysbiotic microbiome on the health of individuals living a long time with HIV on ART are unknown, but many diseases that HIV-positive individuals on ART suffer from at increased incidence have been linked with gut microbiota compositional differences in HIV-negative individuals.