Gut dysbiosis tied to distal neuropathic pain in people with HIV

Distal neuropathic pain (DNP) in people with HIV (PWH) may be partly explained by gut dysbiosis, particularly by lowered diversity and the overabundance of Blautia and Clostridium relative to Lachnospira taxa, a recent study has found.

“The association of neuropathic pain in people with HIV with reduced gut microbial diversity and dysbiosis raises the possibility that re-establishing a healthy gut microbiota might ameliorate neuropathic pain in HIV by reducing proinflammatory and increasing anti-inflammatory microbial products,” the researchers said.

The study included 226 PWH in whom DNP was graded using a validated self-report tool, while 16s rRNA sequencing was used to characterize the gut microbiome; diversity was evaluated using phylogenetic tree construction. A parallel group of 101 individuals without HIV was also included as controls.

While PWH and controls did not significantly differ according to microbiome diversity, as measured by Faith’s phylogenetic diversity, more severe DNP correlated with significantly lower alpha diversity only in PWH (p=0.0007) but not in controls (p=0.748). Such an interaction remained significant even after controlling for demographic or disease factors.

Moreover, the log-ratios of both the Blautia features (p=1.01×10^–3) and Clostridium features (p=6.24×10^–5) to Lachnospira features were significantly higher in PWH patients with vs without DNP. “Thus, relative reductions in Lachnospira abundance might reduce short-chain fatty acids, exacerbating inflammation and neural injury,” the researchers explained.