Abstract
Human immunodeficiency virus (HIV) affects millions of reproductive-age women globally, and during pregnancy is associated with adverse birth and infant health outcomes. Research on how maternal HIV shapes the gut microbiota, a potentially modifiable factor, during pregnancy, postpartum, and in infancy remains limited. The PRACHITi cohort study was conducted in India among 244 pregnant women with and without HIV, who were followed along with their children through 1 year postpartum. Our study focuses on secondary objectives of the PRACHITi study related to gut microbiota, with longitudinal samples being collected in the full cohort and more frequent sampling in a sub-study. Here, our findings reveal gut dysbiosis (based on 16S rRNA sequencing) and distinct plasma metabolomic profiles across pregnancy, postpartum, and their infants among women with HIV compared with seronegative women. We show that specific taxa and metabolites are differentially abundant by HIV status, some of which are linked to adverse outcomes, including preterm birth, low birth weight, and inflammation, conditions that are more common among populations with HIV. These results suggest potential biological pathways through which HIV affects maternal and infant health.