Certain drugs used to control HIV infection also have effects on the bacteria residing in the human intestine and vaginal tract. These are the findings of a study led by the Hospital Clínic de Barcelona and the Barcelona Institute for Global Health (ISGlobal), conducted within the framework of the European project MISTRAL, coordinated by IrsiCaixa. The study, published in the journal Frontiers in Cellular and Infection Microbiology, suggests a potential link between this antibacterial effect and the dysregulation of the microbiome in individuals on lifelong antiretroviral treatment. This may explain the tendency of these individuals to experience chronic complications or acquire multi-resistant bacteria. Additionally, the team has demonstrated the potential of the antiretroviral drug elvitegravir in treating multi-resistant bacteria, specifically those that are gram-positive.
Antiretroviral therapies have significantly enhanced the quality of life for individuals living with HIV, and their life expectancy is now nearly equivalent to that of those without the infection. Nevertheless, the treatment is associated with a heightened risk of encountering certain chronic complications, a phenomenon linked to changes in the microbiome and immune system activation. To explore the connection between microbiome alterations and the effects associated with antiretroviral treatment, the research team evaluated the antibacterial effect of 16 antiretrovirals in the laboratory. Among them, five—Zidovudine, abacavir, efavirenz, bictegravir and elvitegravir—demonstrated antibacterial activity against commensal bacteria in the intestine and vagina. The findings suggest that antiretroviral treatment may disrupt the composition of both the intestinal and vaginal microbiomes, providing potential insights into the long-term effects of the medication.
The study has, for the first time, described the activity of the antiretroviral drug elvitegravir against certain multi-resistant bacteria, specifically the so-called gram-positive ones. This breakthrough underscores the drug’s potent antibacterial capabilities and raises the prospect of repurposing elvitegravir. Introducing an alternative treatment for these bacteria, which currently show resistance to available therapies, could confer a substantial advantage in addressing the global challenge of multidrug resistance—a pressing issue in contemporary public health.
