(1) Background: The gut microbiota plays a crucial role in chronic immune activation
associated with human immunodeficiency virus (HIV) infection, acquired immune deficiency
syndrome (AIDS) pathogenesis, non-AIDS-related comorbidities, and mortality among
people living with HIV (PLWH). The effects of antiretroviral therapy on the microbiome
remain underexplored. This study aims to map the evidence of the impact of integrase
strand transfer inhibitors (INSTI) and non-nucleoside reverse transcriptase inhibitors
(NNRTI) on the gut microbiota of PLWH. (2) Methods: A scoping review was conducted
using PubMed, Web of Science, and Embase, with reports collected following PRISMA
for Scoping Reviews (PRISMA-ScR). (3) Results: Evidence suggests that INSTI-based
regimes generally promote the restoration of alpha diversity, bringing it closer to
that of seronegative controls, while beta diversity remains largely unchanged. INSTI-based
therapies are suggested to be associated with improvements in microbiota composition
and a tendency toward reduced inflammatory markers. In contrast, NNRTI-based treatments
demonstrate limited recovery of alpha diversity and are linked to an increase in proinflammatory
bacteria. (4) Conclusions: Based on the review of the current literature, it is indicated
that INSTI-based antiretroviral therapy (ART) therapy facilitates better recovery
of the gut microbiome.
