Correlation analysis revealed that the loss of protective commensals was positively associated with anti-inflammatory IL-10 levels, while the expansion of opportunistic pathogens was linked to elevated pro-inflammatory IL-6, indicating a microbial-driven immune imbalance.<h4>Conclusions</h4>The results reveal that skin microbiota collapse and the loss of inherent anti-inflammatory defenses are pivotal features of HIV infection with pruritus. The gene discussed is IL6; the disease is Pruritus.