Intestinal Microbiota and Aging in People with HIV—What We Know and What We Don’t

S. M.Shamsul Islam, Shalini Singh, Ali Keshavarzian, Mohamed Abdel-Mohsen*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: People with HIV (PWH) experience premature aging and an elevated risk of age-related comorbidities, even with viral suppression through antiretroviral therapy (ART). We examine gastrointestinal disruptions, specifically impaired intestinal barrier integrity and microbial dysbiosis, as contributors to these comorbidities. Recent Findings: HIV infection compromises the intestinal epithelial barrier, increasing permeability and microbial translocation, which trigger inflammation and cellular stress. ART does not fully restore gut barrier integrity, leading to persistent inflammation and cellular stress. Additionally, HIV-associated microbial dysbiosis favors pro-inflammatory bacteria, intensifying inflammation and tissue damage, which may contribute to premature aging in PWH. Summary: Understanding the interactions between intestinal microbiota, chronic inflammation, cellular stress, and aging is essential to developing therapies aimed at reducing inflammation and slowing age-related diseases in PWH. In this review, we discuss critical knowledge gaps and highlight the therapeutic potential of microbiota-targeted interventions to mitigate inflammation and delay age-associated pathologies in PWH.

Original languageEnglish (US)
Article number9
JournalCurrent HIV/AIDS Reports
Volume22
Issue number1
DOIs
StatePublished - Dec 2025

Funding

M.A-M. is supported by the NIH grants R01AG062383, R01AG062383-04S1, R01NS117458, R01AI165079, R01 DK123733, and R21AI170166. M.A-M is also funded by the NIH-funded BEAT-HIV Martin Delaney Collaboratory to cure HIV-1 infection (1UM1Al126620). A.K and M.A-M are funded by the NIH grants R01AA029859 and R01AA031197.

Keywords

  • Aging
  • HIV
  • Inflammation
  • Metabolites
  • Microbial Dysbiosis
  • Microbial Translocation
  • Microbiome

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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