Microbiome and inflammatory biomarkers related to cardiovascular disease in transgender women with HIV
ABSTRACTBackground: Transgender women with HIV face significant disparities in HIV acquisition, viral suppression, and cardiovascular disease (CVD) risk. These intersecting disparities have raised questions about the role of the gut microbiome and gender-affirming hormone therapy (GAHT) in the pathogenesis of HIV and CVD.Methods: We conducted a preliminary study on a cohort of 21 transgender women with HIV, exploring gut/rectal microbiome composition and its relationship with inflammatory markers associated with CVD risk, as well as differences in microbiome composition and inflammatory markers concerning GAHT use.Results: Microbiome analysis showed no significant differences in alpha diversity metrics (richness, evenness, Shannon diversity) by GAHT use. Beta diversity analysis similarly revealed no significant variation in bacterial composition between participants who used and did not use GAHT. Differential abundance testing did not identify bacteria significantly differentially abundant by GAHT users. Key inflammatory markers related to CVD were associated with GAHT use, with increased sTNFa-I and sTNFa-II levels and decreased IL-1a levels among participants who used GAHT. While the use of exogenous hormones GAHT use does not seem to influence the gut microbial composition, its association with changes in inflammatory markers may carry implications for CVD risk.Conclusions: This study represents an early exploration of the microbiome, CVD risk, and GAHT in transgender women with HIV. Although our results are preliminary and further research with larger, more diverse cohorts is needed, these findings contribute to our understanding of CVD risk in this population and lay the groundwork for potential interventions to address disparities and enhance overall health and well-being in transgender women with HIV. Further research is essential to elucidate the mechanisms underlying these associations, ultimately striving for health equity and CVD risk reduction in this vulnerable population.