Despite early resilience to change, an HIV-1-specific signature in the gut microbiome including depletion of Akkermansia, Anaerovibrio, Bifidobacterium, and Clostridium—previously associated with chronic inflammation, CD8+ T cell anergy, and metabolic disorders—can be identified in chronically HIV-1-infected subjects. The gene discussed is CD8A; the disease is Other metabolic disease.