title: HIV and the gut microbiota, partners in crime: breaking the vicious cycle to unearth new therapeutic targets.
abstract: The gut microbiota plays a key role in health and immune system education and surveillance. The delicate balance between microbial growth and containment is controlled by the immune system. However, this balance is disrupted in cases of chronic viral infections such as HIV. This virus is capable of drastically altering the immune system and gastrointestinal environment leading to significant changes to the gut microbiota and mucosal permeability resulting in microbial translocation from the gut into the peripheral blood. The changes made locally in the gut have far-reaching consequences on the other organs of the body starting in the liver, where microbes and their products are normally filtered out, and extending to the blood and even brain. Microbial translocation and their downstream effects such as increased indolamine 2,3-dioxygenase (IDO) enzyme expression and activity create a self-sustaining feedback loop which enhances HIV disease progression and constitute a vicious cycle of inflammation and immune activation combining viral and bacterial factors. Understanding this self-perpetuating cycle could be a key element in developing new therapies aimed at the gut microbiota and its fallout after infection.
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, QC, Canada H2X 2P4 ; Research Institute, McGill University Health Centre, Montreal, QC, Canada H3H 2R9.
authors.forename: Kishanda
authors.identifier: 0000-0003-0009-8282
authors.initials: K
authors.lastname: Vyboh
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, QC, Canada H2X 2P4 ; Research Institute, McGill University Health Centre, Montreal, QC, Canada H3H 2R9.
authors.forename: Mohammad-Ali
authors.initials: MA
authors.lastname: Jenabian
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, QC, Canada H2X 2P4 ; Research Institute, McGill University Health Centre, Montreal, QC, Canada H3H 2R9.
authors.forename: Vikram
authors.identifier: 0000-0001-8943-2261
authors.initials: V
authors.lastname: Mehraj
authors.affiliation: Chronic Viral Illness Service, McGill University Health Centre, 3650 Saint Urbain, Montreal, QC, Canada H2X 2P4 ; Research Institute, McGill University Health Centre, Montreal, QC, Canada H3H 2R9 ; Division of Hematology, McGill University Health Centre, 687 Pine Avenue West, Montreal, QC, Canada H3A 1A1.
authors.forename: Jean-Pierre
authors.identifier: 0000-0001-9897-7589
authors.initials: JP
authors.lastname: Routy
mesh_terms: D000818:Animals; D000069196:Gastrointestinal Microbiome / Q000276:immunology*; D041981:Gastrointestinal Tract / Q000276:immunology / Q000378:metabolism / Q000382:microbiology / Q000821:virology; D015658:HIV Infections / Q000276:immunology* / Q000628:therapy; D054884:Host-Pathogen Interactions / Q000276:immunology; D006801:Humans; D007107:Immune System; D007167:Immunotherapy; D007413:Intestinal Mucosa / Q000276:immunology / Q000378:metabolism / Q000382:microbiology / Q000821:virology; D053858:Metabolic Networks and Pathways; D014364:Tryptophan / Q000378:metabolism
chemical_list: D014364:Tryptophan