Tripartite interplay: immune reconstitution dynamics in AIDS, gut microbiota, and Helicobacter pylori infection: current advances and therapeutic prospects

Gut Pathog. 2025 Jul 3;17(1):50. doi: 10.1186/s13099-025-00726-z.

Abstract

Background: The immune recovery process in Acquired Immune Deficiency Syndrome (AIDS) is complex and influenced by numerous factors. Gut microbiota and their metabolites play a critical role in maintaining immune homeostasis. Additionally, the presence of Helicobacter pylori in the stomach can affect immune reconstitution in human immunodeficiency virus (HIV)/AIDS patients, either directly or through interactions with the gut microbiota.

Methods: This review adopts a comprehensive literature review approach. It systematically examines a wide range of relevant studies focusing on the interplay between HIV/AIDS immune reconstitution, gut microbiota, and H. pylori.

Results: The review reveals intricate relationships among these components. Gut microbiota and their metabolites are essential for sustaining immune balance. H. pylori influences immune reconstitution in HIV/AIDS patients through various mechanisms, including inducing gut microbiota dysbiosis, altering gastric pH, promoting systemic inflammation, and acting synergistically with HIV. These effects can exacerbate CD4⁺ T cell depletion and may contribute to incomplete immune recovery by disrupting gut microbiota composition.

Conclusion: Understanding these interactions provides a foundation for future research directions. Such insights may offer new perspectives and strategies to address the clinical challenge of immunological non-response in HIV/AIDS patients.

Keywords: Helicobacter pylori; Gut microbiota; Human immunodeficiency virus; Immune reconstitution; Mucosal barrier.