Journal article
Four Weeks of Treatment With Rifaximin Fails to Significantly Alter Microbial Diversity in Rectal Samples of HIV-Infected Immune Non-Responders (ACTG A5286) Which May be Attributed to Rectal Swab Use
Pathogens & immunity, v 4(2), pp 235-250
2019
PMCID: PMC6768152
PMID: 31583331
Abstract
HIV-infected individuals have evidence of intestinal microbial translocation which is associated with immune activation and unfavorable clinical outcomes. Rifaximin, a non-absorbable antibiotic which reduces microbial translocation in other disease states, was shown to have a marginal beneficial effect on microbial translocation, T-cell activation, and inflammation in a multisite randomized trial (ACTG A5286; NCT01466595) of HIV-infected persons with poor immunologic recovery receiving ART. Here, we report analysis of the rectal microbiome changes associated with that trial.
HIV-1-infected individuals receiving ART with CD4-T cell count < 350cells/mm
and viral suppression were randomized 2:1 to rifaximin or no therapy for 4 weeks. Rectal swabs were collected at baseline (pre-treatment) and at week 4 of rifaximin therapy. Genomic DNA extracted from rectal swab samples was analyzed using high throughput sequencing and quantitative PCR of bacterial 16S ribosomal RNA (rRNA) genes.
Forty-eight HIV-infected participants (31 received rifaximin, 17 no treatment) were included. There was broad variability in the recovery of bacterial rRNA from the specimens at baseline. No major significant (FDR
< 0.05) effects of rifaximin treatment on alpha- or beta-diversity or individual taxa were observed between or within the treatment arms, with analyses conducted at taxonomic levels from phylum to genus.
Rifaximin did not meaningfully alter the diversity or composition of the rectal microbiome of HIV-infected individuals after 4 weeks of therapy, although rectal swab specimens varied widely in their microbial load.
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Details
- Title
- Four Weeks of Treatment With Rifaximin Fails to Significantly Alter Microbial Diversity in Rectal Samples of HIV-Infected Immune Non-Responders (ACTG A5286) Which May be Attributed to Rectal Swab Use
- Creators
- Brett B Williams - Rush University Medical CenterStefan J Green - University of Illinois at ChicagoRonald J Bosch - Cancer Research And BiostatisticsEllen S Chan - Cancer Research And BiostatisticsJeffrey M Jacobson - Drexel UniversityDavid M Margolis - University of North Carolina at Chapel HillPhillip Engen - Rush University Medical CenterAlan L Landay - Rush University Medical CenterCara C Wilson - University of Colorado DenverA5286 protocol team
- Publication Details
- Pathogens & immunity, v 4(2), pp 235-250
- Grant note
- UM1 AI068636 / NIAID NIH HHS UL1 TR002548 / NCATS NIH HHS P30 AI050410 / NIAID NIH HHS UM1 AI068634 / NIAID NIH HHS
- Resource Type
- Journal article
- Language
- English
- Scopus ID
- 2-s2.0-85096756807
- Other Identifier
- 991019335319604721