GEM HIV and 
GUT CVD HIV
Research Studies

A black and white image of hands and a medical chart and stethescope with a red AIDS ribbon.

GLP-1, Ethanol, and Gut Microbiome dependent Metabolites in HIV (GEM HIV) Research Study

People with HIV (PWH) are twice as likely to develop cardiovascular disease (CVD) as compared to those without HIV. Some of this extra risk is due to alcohol consumption. Currently, there are very few therapies that exist to effectively reduce alcohol consumption or protect patients from alcohol's harmful effects. However, recently new data from other research studies has shown that the class of medications called glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) may successfully decrease alcohol consumption, thereby lowering a person's risk for developing CVD. GLP-1 receptor agonists are prescription medications that are usually used to treat Type II diabetes or obesity (or example, Ozempic and Trulicity). However, the human body makes the GLP-1 hormone on its own, too. 

This research study, called GEM HIV, is designed to test if increasing the amount of GLP-1 that occurs naturally within the body can reduce alcohol consumption and lower CVD risk for people with HIV just like the prescription medication. It is known that some of the types of metabolites that our gastrointestinal system produces already release GLP-1, and we think that using a probiotic might increase the amounts of these metabolites in the gut, thereby increasing the amount of GLP-1 that the body produces naturally. We will test this hypothesis by collecting an additional blood sample from META HIV CVD RCT participants to see if they have an increased amount of naturally occurring GLP-1 in their blood after taking the META HIV CVD RCT probiotic or placebo. 

We hypothesize that:

  • Alcohol consumption, gut dysbiosis, dysbiosis derived metabolites, and CVD risk are associated with lower endogenous GLP-1 levels among PWH (Aims 1-3).
  • A probiotic will increase endogenous GLP-1 levels (Aim 4).

GEM HIV will advance our understanding of the role of GLP-1 and alcohol, gut dysbiosis and its derived metabolites, CVD risk, and determine whether probiotics increase endogenous GLP-1 levels among PWH who drink alcohol.

Alcohol, Gut derived inflammation, Disturbed Tryptophan Metabolism and CVD risk in People With HIV (GUT CVD HIV)

People living with HIV (PWH) have elevated risks of cardiovascular disease (CVD), and heavy alcohol use is known to be a significant cardiovascular risk factor. Since heavy alcohol drinking and HIV infection are independently associated with the increased risk of CVD, we think their interactive effects are likely to increase the risk of CVD among PWH. However, there is limited understanding of the impact of interactive effects of heavy alcohol drinking and HIV infection on the development of CVD risk in PWH. 

Data from other studies we have conducted suggest that the gut-derived inflammation and immune activation fuels the abnormal immunometabolism and can lead to the development of inflammatory metabolites in the gut. These inflammatory metabolites are known to play a role in the development of CVD. Our previous studies have shown that PWH frequently have increased levels of these inflammatory metabolites that lead to CVD. 

However, the relationship between these metabolites and being diagnosed, particularly in the context of heavy alcohol use, remains largely unknown. This ancillary study of META HIV RCT aims to study these metabolites.