How can the gut microbiota affect immune recovery in HIV-infected individuals?

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The explosion of the microbiome field has shaken our understanding of the pathogenesis of a number of conditions, including HIV disease, in which participation of intestinal bacteria in the course of the disease was far from being suspected. The increasingly appreciated implications in human physiology, including nutrition, metabolism and immunity have open new avenues also in HIV research. Persistence of immune defects, such as sustained activation of the innate and adaptive immunity, during otherwise effective antiretroviral therapy (ART) remains an important clinical challenge, since it contributes to an increased risk of mortality and no therapeutic strategy to date has proved ability to fully reverse these defects. Given the ability of the microbiota to instruct the immune system and control the inflammatory response, expectations about the potential usefulness of targeting the microbiota with interventions to improve the immune recovery and dampen inflammation during HIV infection are high.

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