MISTRAL (Microbiome-based stratification of individuals at risk of HIV-1 acquisition, chronic clinical complications, antimicrobial drug resistance, and unresponsiveness to therapeutic HIV-1 vaccination) is a 5-year EU Horizon 2020 project, running from 1/1/2020 – 31/12/2024.

The project is led by Fundacio Privada Institut de Recerca de la Sida-Caixa CAIXA in Barcelona and aims to explore the gut microbiota in relation to HIV-1, seeking microbiome biomarkers to support development of interventions that mitigate infection and enhance response to vaccines and therapies.
There is emerging evidence that the human microbiome impacts some of the most important clinical aspects of HIV-1 infection, including immune disorders, chronic inflammation and accelerated aging. Work in other viral diseases and cancer immunotherapy suggest a critical role of the human microbiome also in the outcome of immune therapeutic interventions in HIV-1 infection. The MISTRAL project brings together a team of world-class HIV and microbiome researchers and SMEs with ideal complementary knowledge and expertise. This team will work to discover and validate novel gut microbiome biomarkers to inform rationally-designed, mechanistically-driven interventions on the gut microbiome to mitigate HIV-1 acquisition, systemic inflammation, chronic clinical complications, antimicrobial drug resistance, and boost the efficacy of HIV cure immunotherapies.
MISTRAL is nested within the EuroSIDA study, aiming to include microbiome faecal samples and blood samples from 1,000 individuals from established EuroSIDA centres, who will be followed-up for 2-3 years providing a sample at baseline and another follow-up sample (at year 2 or at year 3) for a total of 2,000 faecal and blood samples to be collected and analyzed.

The objectives are to:

• Evaluate the association between the composition and function of the gut microbiome and the risk of development of clinical events (new cardiovascular diseases as well as severe AIDS and other non-AIDS events)
• Evaluate associations between gut microbiome composition and function and level markers of inflammation and coagulation
• Develop a risk score which makes use of information in the gut microbiome as well as other risk factors separately for the different endpoints and a “web-service” interface with a model graphical user interface (GUI).

If successful, MISTRAL will benefit millions of human beings living with, or at risk of acquiring HIV-1 infection, and will produce novel concepts and technical innovations applicable to other human diseases. By doing that, MISTRAL will help to unlock the full clinical potential of the human microbiome to stratify patient outcomes and will irreversibly bring microbiome science closer to clinical practice.

Main Funding Body