Project dates: February 2020 - January 2025
Chronic HIV infection produces pathologic inflammation which drives disease progression and contributes to the development of serious co-morbid medical conditions, even in the setting of effective combination antiretroviral therapy (CART); translocation of bacterial products across the gastrointestinal (GI) mucosa is a major antigenic stimulus for this process.
This study focuses on how vagal dysfunction (VD), which occurs commonly as part of HIV-associated neuropathy, affects GI and immune function in HIV. This project seeks to establish that small intestinal dysmotility and hypochlorhydria mediate the relationship between VD and small intestinal bacterial overgrowth (SIBO), and to describe the changes in the GI microbiome in PLWH with SIBO. The study will also determine whether VD is associated with elevations in IL-6 and TNFα independent of SIBO, establish to what degree the strength of these relationships depend on the presence of HIV infection, and whether they are reversible using pyridostigmine and/or non-invasive vagal nerve stimulation (nVNS).
Abstract on NIH RePORTER