The Influence of Gut Microbiota on Pregnancy Outcome Among HIV-infected Women in Lagos, Nigeria

Background Gut microbiota plays a crucial role in maternal metabolism, immune regulation, and pregnancy outcomes. However, HIV infection disrupts gut microbiota diversity, potentially leading to adverse pregnancy outcomes. Nigeria bears a high burden of HIV among pregnant women, yet the relationship between gut microbiota diversity and pregnancy outcomes in this population remains underexplored. Objective This study aimed to investigate the association between gut microbiome diversity and pregnancy outcomes among HIV-infected pregnant women in Lagos, Nigeria. Methods A comparative cross-sectional study was conducted involving 100 pregnant women (50 HIV-positive and 50 HIV-negative) in Lagos, Nigeria. Socio-demographic, clinical, and dietary data were collected using structured questionnaires. Blood samples were analyzed for CD4 count, HIV viral load, and co-infections (HBV and HCV). Fecal samples underwent microbial culture and 16S rRNA sequencing for gut microbiota characterization at the Centre for Human Virology and Genomics, Nigerian Institute of Medical Research. Pregnancy outcomes were assessed and compared between the two groups. Results HIV-infected pregnant women exhibited significantly reduced gut microbial diversity and a higher prevalence of Candida albicans (78% vs. 20%; p < 0.001) compared to HIV-uninfected women. Adverse pregnancy outcomes, including low birth weight (30% vs. 7.7%; p = 0.004) and preterm birth, were more frequent among HIV-infected women. Proteus mirabilis was significantly associated with adverse pregnancy outcomes in the HIV-positive group (p = 0.023). The HIV-positive group also had lower immune status, with 20% showing CD4 counts below 350 cells/µL compared to 2% in the HIV-negative group (p = 0.004). Hepatitis B surface antigen (HBsAg) positivity was higher in HIV-positive pregnant women (16%) than in HIV-negative women (2%; p = 0.012). Dietary intake varied, with HIV-infected women consuming fewer dairy products and less folic acid supplementation. Conclusion This study highlights the complex interplay between HIV-associated gut dysbiosis and adverse pregnancy outcomes. Modulation of the gut microbiota, alongside antiretroviral therapy, may improve maternal and neonatal health outcomes. These findings provide valuable insight into the microbiome’s role in pregnancy among HIV-infected populations in Nigeria and suggest potential therapeutic targets for reducing pregnancy complications.