Objectives: Despite longer life expectancies, those aging with HIV experience increased comorbidity and other health challenges relative to the general population. Alterations in the composition of the gut microbiome are associated with increased immune activation and aging, but few studies have explored the association of the gut microbiome with adverse age-related outcomes in people living with HIV. We assessed the relationship between gut microbiome composition and healthy aging in HIV.
Design/methods: The CHANGE HIV study is a Canadian cohort of people aged 65 and older, which aims to investigate correlates of healthy aging in HIV. Rectal swabs were collected at enrolment from a subset of 158 consenting participants, which we analyzed with 16S rRNA gene sequencing to characterize the gut microbiome. Healthy aging was quantified using the Rotterdam Healthy Aging Score (HAS) and categorized as healthy (13-14), intermediate (11-12), and poor (0-10). We collected other markers of healthy aging including cognition, frailty, and demographics.
Results: Gut microbiome diversity did not differ based on HAS category, although some disease-associated bacteria were enriched in participants with lower HAS. Gut microbiome diversity did not differ based on age or frailty status. Lower HAS score group was associated with lower household income, poorer nutrition and cognition, and earlier year of HIV infection.
Conclusion: Gut microbiome composition was not associated with healthy aging as defined by the HAS, although there were weak associations between HAS and disease-associated bacterial genera. Interventions that target social circumstances may provide greater improvements in health among aging persons with HIV.
Keywords: HIV; aging; frailty; geriatric; microbiome; microbiota.
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.