Advanced HIV-1 infection is associated with gut dysbiosis, and it’s not known whether this is reversed with antiviral therapy. The ADVANZ-4 MISTRAL trial shows that dolutegravir restores gut microbiota in late-stage HIV1 patients better than darunavir, and that recovery is linked to improved immune reconstitution.

Today we publish in #NatureCommunications evidence that dolutegravir, unlike darunavir, helps restore the gut microbiome in people presenting late with HIV In our multicentre, open‑label RCT (96 week...

Can specific HIV drugs heal the gut? For late-stage patients, viral suppression isn't enough to stop chronic inflammation. Our 2-year trial reveals that dolutegravir, unlike darunavir, profoundly restores the gut microbiome, offering a new pathway to long-term health and reduced inflammation.