Alterations of the skin microbiome in HIV infection with pruritus

Abstract

Introduction: Pruritus is one of the main common symptoms of human immunodeficiency virus (HIV) infection. Skin changes caused by scratching, or the absence of skin findings despite ongoing pruritus, impact patients' quality of life. With cutaneous HIV infection, pruritus is continuous, though it is unknown whether HIV infection affects the skin microbiota to cause pruritus.

Methods: The skin microbiomes and plasma of HIV infection with pruritus, HIV and healthy were investigated in this study. Swabs were taken from four body sites and the composition of the microbiome at those sites was assessed using 16S rRNA amplification. Cytokines(interleukins 10 and 6) in plasma were detected by enzyme-linked immunosorbent assay.

Results: The skin microbiome in the pruritus group was characterized by a significant depletion of protective commensals, specifically Cutibacterium and the Burkholderia-Caballeronia-Paraburkholderia. Conversely, opportunistic microbiome, including Prevotella and Leptotrichia, were markedly enriched and identified as key microbial signatures by Random Forest analysis. Correlation analysis revealed that the loss of protective commensals was positively associated with anti-inflammatory IL-10 levels, while the expansion of opportunistic pathogens was linked to elevated pro-inflammatory IL-6, indicating a microbial-driven immune imbalance.

Conclusions: The results reveal that skin microbiota collapse and the loss of inherent anti-inflammatory defenses are pivotal features of HIV infection with pruritus.

Keywords: 16S rRNA sequencing; HIV; HIV-associated pruritus; microbial biomarkers; skin microbiome.