{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:22:03Z","timestamp":1778595723283,"version":"3.51.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The gastrointestinal tract serves as a major viral reservoir in HIV infection, and persistent gut dysbiosis contributes to systemic inflammation and immune dysfunction despite effective antiretroviral therapy (ART). Integrase strand transfer inhibitor (INSTI)\u2013based regimens are now preferred for their efficacy and tolerability; however, their impact on gut microbial restoration remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study analyzed fecal microbiota composition in 30 HIV-positive adults\u201410 ART-na\u00efve, 7 receiving INSTI-based ART for &amp;lt;2\u202fyears, and 13 receiving INSTI-based ART for 2\u20135\u202fyears. 16S rRNA gene sequencing of stool samples (V3\u2013V4 regions) was performed to evaluate bacterial diversity and taxonomic shifts. Microbial composition was compared across groups and correlated with CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Alpha diversity showed a non-significant yet progressive increase from ART-na\u00efve to long-term INSTI-treated patients, suggesting partial restoration of microbial diversity. At the phylum level, Firmicutes increased and Bacteroidetes decreased in treated groups, indicating a shift toward eubiosis. Long-term INSTI therapy enriched beneficial taxa such as\n                      <jats:italic>Faecalibacterium prausnitzii, Lactobacillus ruminis, Eubacterium biforme,<\/jats:italic>\n                      and\n                      <jats:italic>Bifidobacterium longum<\/jats:italic>\n                      , while reducing pro-inflammatory\n                      <jats:italic>Bacteroides fragilis<\/jats:italic>\n                      and\n                      <jats:italic>Haemophilus parainfluenzae<\/jats:italic>\n                      . Moreover, higher CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts showed a positive correlation with the abundance of short-chain fatty acid\u2013producing bacteria and with an increased Firmicutes\/Bacteroidetes ratio, indicating improved mucosal integrity and immune homeostasis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrase inhibitor\u2013based ART promotes partial normalization of gut microbiota composition in HIV-infected patients, enhancing beneficial taxa linked to immune recovery. These findings underscore the potential of microbiota-targeted adjunctive interventions\u2014such as probiotics or dietary modulation\u2014to support mucosal immunity and long-term health in people living with HIV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1814926","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:00:31Z","timestamp":1778594431000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrase inhibitor\u2013based antiretroviral therapy drives gut microbiota remodeling and immune recovery in HIV infection"],"prefix":"10.3389","volume":"13","author":[{"given":"Banu","family":"Karaca","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Atat\u00fcrk Training and Research Hospital, Katip \u00c7elebi University","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alper","family":"\u015eener","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Atat\u00fcrk Training and Research Hospital, Katip \u00c7elebi University","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Figen","family":"Kaptan","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Atat\u00fcrk Training and Research Hospital, Katip \u00c7elebi University","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Ece","sequence":"additional","affiliation":[{"name":"Department of Basic Oncology, Institute of Health Sciences, Ege University","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahar","family":"\u00d6rmen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Atat\u00fcrk Training and Research Hospital, Katip \u00c7elebi University","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayse","family":"Caner","sequence":"additional","affiliation":[{"name":"Department of Basic Oncology, Institute of Health Sciences, Ege University","place":["Izmir, T\u00fcrkiye"]},{"name":"Department of Parasitology, Faculty of Medicine, Ege University","place":["Izmir, T\u00fcrkiye"]},{"name":"Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Ege University","place":["Izmir, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1038\/ni.1825","article-title":"Enteric defensins are essential regulators of intestinal microbial ecology","volume":"11","author":"Salzman","year":"2010","journal-title":"Nat 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