(P19-009-25) Nutrition, Gut Composition & Diversity in Children With Perinatal HIV (CPHIV), Children HIV-Exposed Uninfected (CHEU) and Children HIV Unexposed Uninfected (CHUU)

Objectives: To test the hypothesis that vitamin- B-12 and Ω3-polyunsaturated fatty acid (PUFA) sufficiency beneficially impact gut microbial richness and diversity in perinatally HIV-affected children and control CHUU.

Methods: A sample of 95 children were recruited as part of a pilot study. Sufficient ( >300 pm/L), sub-clinical deficiency (200 – 300 pm/L) and deficient ( < 200 pm/L) vitamin B12 as well as Ω3-PUFA level (analyzed in terciles) were measured in serum. The richness and evenness of microbial species in gut were calculated using stool samples subjected to 16 sRNA sequencing from which gut microbial richness/diversity per the Shannon Index for each child. Linear regression models adjusted for sampling design were implemented in Statistical Analysis Software (V9.4) to estimate perinatal HIV-status, vitamin B12, and Ω3-PUFA associated mean differences (MD) for continuous Shannon index and logistic regression model estimated the odds of being classified as having high (i.e., top tercile) vs. low (i.e., ≤ 2^nd tercile) alpha diversity with corresponding 95% Confidence Interval (CI) after adjustment for child-age and sex.

Results: A total of 44 CPHIV, 31 CHEU, and 29 CHUU were enrolled. Relative to CHUU, CHEU (OR=0.42, 95%CI: 0.013, 1.36), and CPHIV (OR=0.23, 95%CI: 0.07, 0.77) status were each associated with lower odds of having highly diverse gut microbiome. Overtly B12 deficient (MD=-1.1, 95%CI: -1.7, -0.46) and sub-clinically deficient (MD=-0.40, 95%CI: -1.02, 0.23) vs. B12 sufficient status associated with lower α-diversity score. Being in the lowest vs moderate or highest (MD=-0.86 to -0.60, 95%CI:-1.4, -0.00) tercile of serum Ω3-PUFA associated with lower α-diversity.

Conclusions: Perinatal HIV status, B-12 deficiency, and low Ω3-PUFA are each independent determinants of gut microbial richness and diversity among children from Kampala Uganda. Supplementation with B12 and Ω3-PUFA may be viable strategies for improving gut health with downstream benefits for overall well-being in vulnerable populations with and without chronic HIV infection/exposure.

Funding Sources: National Institutes of Neurological Diseases and Strokes