Sociodemographic Factors Have Nuanced Effects on the Gut Microbiome of HIV-Positive Patients in Zimbabwe

Abstract

Human Immunodeficiency Virus (HIV) remains a significant public health issue in sub-Saharan Africa, which accounts for approximately 70% of global HIV cases, with antiretroviral therapy (ART) treatment often limited by suboptimal coverage and inadequate responsiveness in many patients. One potential factor influencing ART outcomes is the gut microbiota (GM) composition and diversity, as HIV infections can occur in gut lymphoid tissue. Furthermore, previous research has found that our GM is strongly influenced by sociodemographic factors, such as occupation, income, diet and more. Unfortunately, research linking these sociodemographic factors to the gut microbiota in HIV-positive (HIV+) patients is limited, primarily due to the lack of consideration for these factors and thus lack of comprehensive sociodemographic data collected in previous studies. This study uses a dataset collected from Colorado et al. in 2024, which includes extensive sociodemographic information along with 16S rRNA sequencing data from ART-naïve and ART-experienced HIV+ patients in both rural and urban areas of Zimbabwe. Here, we examined the effects of sociodemographic factors—age, education, and occupation—on the GM. Results showed non-significant differences in alpha and beta diversity across sociodemographic factors, except for age, where patients aged 45 and under exhibited a more even GM compared to those over 45. Analysis of core microbiome and indicator species revealed few distinct species across sociodemographic factors, with patients who completed tertiary (e.g. university level, craft schools, or colleges) education having higher levels of species such as Alloprevotella sp., Sanguibacteroides justesenii, Negativibacillus sp., and Anaerotruncus sp. Functional pathway analysis using PICRUSt2 showed that higher levels of education were associated with upregulation of five metabolic pathways, while age affected one pathway. These findings indicate that sociodemographic factors subtly influence the GM in HIV+ patients in Zimbabwe, highlighting the importance of incorporating sociodemographic factors in understanding and “humanizing” gut microbiota data.