Gastrointestinal Dysmotility, Autonomic Function, and Small Intestinal Bacterial Overgrowth Among People With...

Area of Science:

• Gastroenterology
• Infectious Diseases
• Neurology

Background:

• Gastrointestinal dysfunction and microbiome changes are implicated in chronic inflammation for people with HIV (PWH).
• The role of autonomic neuropathy (AN) in altering gastrointestinal motility in PWH remains unclear.

Purpose of the Study:

• To investigate the relationship between autonomic function and gastrointestinal motility in PWH.
• To explore potential links between altered motility, small intestinal bacterial overgrowth (SIBO), and symptoms in PWH.

Main Methods:

• Cross-sectional study of 100 PWH and 89 controls.
• Wireless motility capsule (WMC) for gastrointestinal transit times.
• Autonomic function tests (MCASS), SIBO breath testing, and symptom questionnaires (PAGI-SYM, COMPASS-31).

Main Results:

• PWH had faster gastric emptying (GET) and slower small bowel (SBTT) and colonic transit times (CTT) than controls.
• Peripheral sympathetic function (MCASS sudomotor score) correlated with SBTT in PWH.
• Prolonged SBTT (>6h) was associated with a higher likelihood of SIBO in PWH.

Conclusions:

• Gastrointestinal motility is significantly altered in PWH.
• Autonomic dysfunction may influence small bowel transit times in PWH, potentially contributing to SIBO.
• Further research is required to clarify the links between HIV-associated AN, motility, microbiome, inflammation, and clinical outcomes.