Abstract Details

Title Association of Vagal Dysfunction and Prolonged Small Bowel Transit Time with Small Intestinal Bacterial Overgrowth Among People with HIV

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-011

Objective To establish whether prolonged small bowel transit time (SBTT) and/or gastric pH mediate a relationship between vagal dysfunction (VD) and small intestinal bacterial overgrowth (SIBO) in people with HIV (PWH).

Background HIV-associated autonomic neuropathy (HIV-AN) is common and VD is part of HIV-AN. However, the associations between VD and end organ dysfunction are unknown. This is particularly relevant in the gastrointestinal (GI) system given vagal control proximal GI motility, and the role of increased translocation of GI microbial products as a stimulus for abnormal immune activation in PWH.

Design/Methods This is an ongoing cross-sectional study which (as of this writing) has complete baseline data on 50 people with well-controlled HIV. Participants underwent: 1) a standardized battery of autonomic function tests (AFTs), 2) glucose breath testing for SIBO; and 3) assessment of GI transit times and pH using a wireless motility capsule (WMC). VD was defined as a Composite Autonomic Severity Score (CASS) cardiovagal sub-score of at least one (based on the AFTs).

Results The mean age of participants was 50 (SD=12) years; 78% were men; 46% black, 24% white and 24% Hispanic/Latinx. Twenty-nine (58%) participants met criteria for VD and 24 (48%) met criteria for SIBO. Among participants with VD, SIBO (defined as the increase in methane and hydrogen content in the breath following glucose ingestion) was significantly greater (22.8 vs 11.5 ppm; p=0.038). There was also an association between SBTT and SIBO (B= 0.097, p=0.011) However, participants with VD did not experience prolonged SBTT (5.8 vs. 5.1 hours, p=0.492) or differences in minimum gastric pH (1.2 vs .99, p=0.483).

Conclusions

Among PWH, both VD and SBTT are associated with SIBO but not with one another. Additional research is needed to determine the mechanisms by which HIV-AN interacts with GI motility and dysbiosis.

Authors/Disclosures
Mitali Mehta (Icahn School of Medicine at Mount Sinai) PRESENTER	Dr. Mehta has nothing to disclose.
Niyati Neupane	No disclosure on file
Zhan Zhao	No disclosure on file
Emma Benn	No disclosure on file
Jessica Robinson Papp, MD, FAAN (Icahn School of Medicine At Mount Sinai)	Dr. Robinson Papp has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Immgenuity Inc. Dr. Robinson Papp has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuropathix Inc. The institution of Dr. Robinson Papp has received research support from NIH. Dr. Robinson Papp has received publishing royalties from a publication relating to health care.

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