The Putative Role of Oral Microbiome in Premature Aging during HIV Infection: What Do We Know?

Despite improvements in life expectancy, people with HIV (PWH) are at risk of developing HIV-associated comorbidities at a younger age when compared to HIV-uninfected individuals. This premature aging process can be attributed to various factors, such as the prolonged exposure to combination antiretroviral therapy (cART), inflammation, microbial perturbances and oxidative stress. Similarly to the gut, oral dysbiosis occurs in HIV-1 infection, with cART and inflammation playing a crucial role. This gives rise to an enrichment of pathogenic microorganisms that in turn, elicit an immune response tied to chronic inflammation. Consequently, cART exposure, dysbiosis and persistent inflammation in HIV-1 infection have been associated with the production of reactive oxygen species, mitochondrial dysfunction and telomere shortening, which are known hallmarks of aging. Although looking into these factors provides insight into the mechanisms underlying premature aging in PWH, there is still much we do not know about the oral microbiome and its relationship to HIV-1 infection. The objective of this review is to synthetize current evidence to better elucidate the role of the oral microbiome in HIV-1 infection and its contribution to inflammation and oxidative stress. By addressing these gaps, we aim to provide a novel perspective on the premature biological aging process in PWH and ultimately improve overall health in this population.