eLetters is an online forum for ongoing peer review. Submission of eLetters are open to all. Please read our Terms of Service before submitting your own eLetter.
- RE: Altered gut microbiome in HIV-exposed infants: Delivery mode, Maternal microbiome and Medicines
We read with great interest the recent publication by Bender et al; ”Maternal HIV infection influences the microbiome of HIV-uninfected infants” 1. As HIV-uninfected infants born by HIV-infected mothers have twice the mortality of matched unexposed infants, identifying potential triggering factors is of utmost importance. The microbiome could be one such factor, as the infant microbiome is to a large degree inherited from the mother.
Show More
The authors report that HIV-uninfected infants born by HIV-infected mothers have a dysbiotic gut microbiome, with reduced biodiversity compared to the microbiome of unexposed infants. Interestingly, they find the lowest alpha diversity in infants delivered by the mothers with the lowest CD4+ T cell count, and those with a detectable viral load despite antiretroviral therapy (ART), suggesting a link between infant dysbiosis and maternal immunodeficiency. The authors also propose a link to differences in the composition of the mothers' breast milk.
These findings are of potential interest from a translational perspective, strengthening the case of dysbiosis as a potential driver of immune dysfunction, and also from a clinical perspective, as the gut microbiome is a potential therapeutic target. Hence, the interpretation of these data is important, and we would like to add some potentially contributing factors to the discussion.
1. Mode of delivery. Although not significantly different (p=0.10), there was a numerical increa...Competing Interests: None declared.