Fabio Antonino Ranzani, Chiara Montrucchio, Ilario Ferrrocino, Donatella Penoncelli, Ilaria Cavecchia, Cristina Tettoni, Micol Ferrara, Andrea Pezzana, Alice Palermiti, Alessandro Lazzaro, Stefano Bonora, Giovanni DiPerri, Andrea Calcagno
In this pilot study assessing a tailored dietary intervention in high CV-risk PWH, we observed stable metabolic and inflammatory parameters and an unexpected increase in TMAO levels at 6 months. Microbiome composition was marginally affected, and active interventions are probably needed to elicit significant changes over time.
BACKGROUND: People with HIV (PWH) are at higher risk of cardiovascular disease (CVD) despite spontaneous or antiretroviral therapy-induced long-lasting suppressed viremia. Traditional and HIV-specific factors have been identified, but CVD incidence and mortality remain high. A microbiome is a community of germs living close to their human host, and bacterial dysbiosis is associated with atherosclerosis and chronic non-communicable disease development.
METHODS: We conducted a pilot study designed to analyze the effect of tailored diet intervention on body mass index (BMI), metabolic features and microbiota composition in PWH with suppressed HIV viremia (HIV RNA <50 copies/mL) under combination antiretroviral treatment. Biomarkers and parameters were measured at baseline and 6 months (M6) after.
RESULTS: Ten male participants were enrolled. The median age was 60.5 years (54-69) and the 10-year CV risk was 11.7% (7.2-21.2). CD4+ T lymphocyte count was 568 cells/mm3 (398-625). Approximately 75% of participants declared to be adherent to the given dietary recommendations. Participants showed reduced amounts of food intake (p = 0.022) and, specifically, of saturated fat (p = 0.007) and cholesterol (p = 0.011). At M6, most metabolic and inflammatory parameters remained stable. TMAO concentrations were higher at M6 than at baseline (157 vs. 129 ng/mL, p = 0.050). Microbiota alpha and beta diversity did not change over time: yet we observed a significant reduction of Firmicutes (p = 0.047) and an increase in Proteobacteria (p = 0.028) relative abundance at M6.
CONCLUSIONS: In this pilot study assessing a tailored dietary intervention in high CV-risk PWH, we observed stable metabolic and inflammatory parameters and an unexpected increase in TMAO levels at 6 months. Microbiome composition was marginally affected, and active interventions are probably needed to elicit significant changes over time.