Wang Mengyan, Dong Xiaotian, Wan Hu, Shi Jinchuan, Hui Lu, Chen Wei, Liu Shourong, Yan Jun
Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Xixi Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou, China.
Department of Laboratory Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
J Cell Mol Med. 2025 Sep;29(17):e70832. doi: 10.1111/jcmm.70832.
To characterise T-cell immunity and inflammatory profiles in HIV patients with mycobacterial co-infections. This study enrolled 41 HIV patients co-infected with Mycobacterium tuberculosis (HIV-TB, n = 27) or non-tuberculous mycobacteria (HIV-NTM, n = 14), along with 30 controls (20 HIV-monoinfected, 10 post-treatment) from a single centre. Flow cytometry quantified T-cell subsets (CD3 + CD4+, CD3 + CD8+, CD28+ subsets), mitochondrial parameters (mass [MM], low membrane potential [MMP-low%]) and cytokines (IFN-γ, IL-2/4/6/10/17A, TNF-α). Co-infected groups showed reduced T-cell counts versus HIV-monoinfected controls (p < 0.05). Elevated MMP-low% in CD3 + CD4+/CD28+ T cells indicated mitochondrial dysfunction in co-infected patients (p < 0.05). HIV-TB patients exhibited higher CD3 + CD4+/CD28+/CD8+ T-cell MM than HIV-NTM (p < 0.05), while HIV-NTM demonstrated greater MMP-low% (p < 0.05). Proinflammatory cytokines (IFN-γ, IL-6, IL-17A) inversely correlated with CD4+ counts and MM, but positively with CD8 + CD28+ MMP-low%. MMP-low% in CD3 + CD4 + CD28+ T cells and IL-2 differentiated IRIS/non-IRIS cases (p < 0.05), with combined AUC = 0.834 for IRIS prediction (p = 0.001). HIV/mycobacterial co-infection exacerbates T-cell depletion and mitochondrial dysfunction, with HIV-NTM showing more severe impairment. MMP-low% and IL-2 may serve as biomarkers for IRIS risk stratification.
为了描述合并分枝杆菌感染的HIV患者的T细胞免疫和炎症特征。本研究纳入了41例合并结核分枝杆菌感染的HIV患者（HIV-TB，n = 27）或非结核分枝杆菌感染的HIV患者（HIV-NTM，n = 14），以及来自单一中心的30名对照（20例HIV单感染患者，10例治疗后患者）。流式细胞术对T细胞亚群（CD3 + CD4 +、CD3 + CD8 +、CD28 +亚群）、线粒体参数（质量[MM]、低膜电位[MMP-low%]）和细胞因子（IFN-γ、IL-2/4/6/10/17A、TNF-α）进行定量分析。与HIV单感染对照组相比，合并感染组的T细胞计数降低（p < 0.05）。CD3 + CD4 + /CD28 + T细胞中MMP-low%升高表明合并感染患者存在线粒体功能障碍（p < 0.05）。HIV-TB患者的CD3 + CD4 + /CD28 + /CD8 + T细胞MM高于HIV-NTM患者（p < 0.05），而HIV-NTM患者的MMP-low%更高（p < 0.05）。促炎细胞因子（IFN-γ、IL-6、IL-17A）与CD4 +计数和MM呈负相关，但与CD8 + CD28 + MMP-low%呈正相关。CD3 + CD4 + CD28 + T细胞中的MMP-low%和IL-2可区分免疫重建炎症综合征（IRIS）/非IRIS病例（p < 0.05），联合AUC为0.834用于IRIS预测（p = 0.001）。HIV/分枝杆菌合并感染会加剧T细胞耗竭和线粒体功能障碍，其中HIV-NTM表现出更严重的损伤。MMP-low%和IL-2可作为IRIS风险分层的生物标志物。
