Intestinal microbiome changes in response to amino acid and micronutrient supplementation: secondary analysis of the AMAZE trial

An article in Gut Microbiome, published September 8, 2025

Authors: Monica N Mweetwa, Kazi Ahsan, John Louis-Auguste, Ellen Besa, Joram M Posma, Nathan McNulty, Micheal J Barrat, Jeff Gordon, Paul Kelly 


This study looked at how supplementing with amino acids and micronutrients impacts the gut microbiome in adults with environmental enteropathy (EE), a condition affecting nutrient absorption. Researchers divided participants into groups receiving either amino acids, micronutrients, both, or a placebo over 16 weeks and collected samples from their small intestine and stool for analysis.

The study found that amino acid and micronutrient supplementation did not significantly change the overall variety or abundance of gut bacteria compared to the placebo. However, there were some specific shifts in the presence of certain bacteria and their metabolic functions. For instance, micronutrient supplementation increased the activity of pathways related to the production of beneficial short-chain fatty acids. This research suggests that while generalized microbial diversity may not be affected, specific beneficial changes in the gut microbiome could occur with targeted nutrient supplementation. Future studies are needed to understand if these microbiome adjustments have meaningful health benefits.

This study is particularly relevant for HIV researchers and practitioners because it addresses the gut microbiome's response to nutrient supplementation in individuals with EE, a condition often found in low-resource settings where HIV is also prevalent. Given that both EE and dysbiosis are common in HIV-positive populations, this study's findings could inform integrated treatment strategies addressing both conditions simultaneously, potentially improving patient outcomes.

Overall, this research underscores the importance of considering gut health and nutrition in the management of HIV, highlighting the potential benefits of targeted nutritional supplementation as part of a broader treatment regimen.

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