ArticleBMC microbiology2025
Differential effects of switching to integrase strand transfer inhibitors on the gut microbiota and markers of HIV disease progression.
Article in BMC microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Limited impact of HIV infection and immune status on the gut mycobiota.BMC microbiology · 2026Article
- Different Trends of Immune Activation Markers When Switching to Either Oral or Injectable Dual Antiretroviral Therapy Based on Integrase Inhibitors in People Living with HIV.Pathogens (Basel, Switzerland) · 2026Article
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Authors and funding
11 authors.
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Abstract
backgroundUnwanted weight gain is often reported in people living with HIV (PWH) who start on or switch to integrase strand transfer inhibitors (INSTI). Mechanisms are incompletely understood. An unintended off-target of INSTI might be the gut microbiota.
methodsWe explored the fecal microbiota of treated aviremic PWH (n = 70) who switched from efavirenz (EFV)- to a bictegravir (BIC)-based regimen. 16S rRNA sequencing, and enzyme-linked immunosorbent assays were used to characterize the fecal microbiota and quantify markers of HIV disease progression. A cohort of high-risk HIV-negative individuals (n = 18) was included to address differential effects of antiretroviral therapy (ART) on the fecal microbiota.
resultsThis real-life cohort was predominantly male (n = 63) and mostly men who have sex with men (n = 40). All PWH were on the same antiretroviral regimen for at least 1 year; the mean time on ART was 10.83 ± 5.530 years and all had undetectable plasma viral loads (< 40 HIV-1 RNA copies/mL). PWH gained a median weight of 3.375 kg and the mean percent weight change relative to baseline was 4.32%. Seven (10%) PWH gained significant weight (> 10% relative to baseline). Switching to a BIC-based regimen had contrasting effects. PWH on BIC/FTC/TAF showed decreased microbial translocation (soluble CD14, sCD14), decreased enterocyte damage (intestinal fatty-acid binding protein, I-FABP), and increased alpha diversity (richness and shannon); all indicative of a better restoration of the gut mucosa and microbiota. Conversely, increases in sCD163, monocyte chemoattractant protein 1 (MCP-1) and decreases in adiponectin, markers linked to cardiovascular disease, insulin resistance and adiposity, were unfavorable.
conclusionOur data suggest that INSTI have a less detrimental effect on the gut microbiota compared to EFV-based regimen. The link between weight gain on INSTI and the gut microbiota was not readily apparent.
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