Thesis title: GUT MICROBIOTA COMPOSITION IN HIV-EXPOSED UNINFECTED CHILDREN IN THE LOW AND MIDDLE-INCOME SETTINGS: A COMPARATIVE STUDY BASED ON 16S RRNA SEQUENCING WITH HIV-UNEXPOSED CONTROLS
The successful prevention of vertical paediatric HIV transmission has led to an expanding cohort of 16 million HIV-exposed uninfected children under 15 years of age, with 90% of them living in sub-Saharan Africa. These children face some health challenges from birth due to their exposure to HIV and antiretroviral therapy, associated with adverse maternal outcomes. The gut microbiome plays a crucial role in human health, influencing the development of chronic diseases such as HIV infection and shaping immune responses.
This study examines the impact of perinatal exposure to HIV and ART on the microbiota of HEU children in Cameroon, employing the gold standard 16S rRNA sequencing method. The two study groups, exposed and unexposed, uninfected children, were balanced in terms of clinical and demographic characteristics and showed no significant differences in alpha diversity. However, the Weighted Unifrac analysis revealed phylogenetic differences (Pseudo-F=2.91, p=0.026), indicating a microbial imprint associated with perinatal and postnatal exposure. HEU children demonstrate microbial resilience, maintaining alpha diversity and showing a predominance of Prevotella, which is typical of fibre-rich diets. Exposure to HIV/ART, as well as prophylaxis with cotrimoxazole, even through maternal breastfeeding, leaves a persistent phylogenetic imprint on the gut microbiome.