P106: MOUD Exacerbates the Distinctive Metabolic Patterns Associated with HIV Infection and Suppressive ART
Poster Presenter
Ekaterina Shipilova
PhD Candidate
The Wistar Institute/The University of Bologna United States
Objectives
People living with HIV (PLWH) experience persistent metabolic alterations despite antiretroviral therapy (ART). Medications for opioid use disorder (MOUD; methadone and buprenorphine) may induce immunomodulatory effects and metabolic reprogramming in ART-suppressed PLWH.
Method
This was a cross-sectional observational cohort study. Plasma samples were collected from a total of 194 participants: ART-suppressed PLWH (HIV; n=57), ART-suppressed PLWH receiving MOUD (HIV-MOUD; n=31), and healthy controls (CTRL; n=106). The cohort included 43.8% females and 53.1% non-white parti
Results
In HIV versus CTRL, the most significant enrichment was in androgen/estrogen metabolism, with sulfated steroids (DHEA-S, androsterone sulfate) significantly reduced. In HIV-MOUD versus HIV, MOUD exposure further suppressed sulfated steroids and testosterone. Zeta-carotene was consistently reduced across comparisons, suggesting impaired antioxidant capacity. IPA confirmed overlapping disruptions and highlighted pathways related to inflammation, endocrine function, and gastrointestinal disease.
Conclusion
This study demonstrates that ART-suppressed PLWH show metabolic reprogramming characterized by steroid hormone disruption, which is exacerbated by MOUD exposure. Sulfated steroids emerge as key metabolic signatures with implications for endocrine, immune, and systemic health.
