Frequency of CXCR3+ CD8+ T-Lymphocyte Subsets in Peripheral Blood Is Associated With the Risk of Paradoxical Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome Development in Advanced HIV Disease

Analysis of the expression characteristics and clinical value of immune function indicators in patients with human immunodeficiency virus infection

Objective

To explore the expression characteristics and clinical value of immune function indicators in patients with human immunodeficiency virus (HIV) infection.

Methods

In this retrospective study, clinical data of 196 patients with HIV infection (observation group) and 196 health examinees (control group) admitted to our hospital from November 2021 to March 2023 were retrospectively analyzed. Patients in the observation group were further classified based on the staging as acute phase (n=53), asymptomatic phase (n=65), and acquired immunodeficiency (AIDS) phase (n=78). Levels of immune function indicators in the observation group and the control group were compared, and the correlation between immune function index levels and disease staging was analyzed.

Results

Levels of CD3+, CD4+, CD4+/CD8+, B cells, and NK cells were lower in the observation group (P<0.05), were significantly lower in asymptomatic patients compared with patients in the acute phase (P<0.05), and were significantly lower in patients with AIDS than those in asymptomatic patients (P<0.05). The results for CD8+ were in contrast to the above(P<0.05). Spearman analysis confirmed that levels of CD3+, CD4+, CD4+/CD8+, B cells and NK cells significantly negatively correlated, and levels of CD8+ significantly positively correlated with the stages of HIV (P<0.05).

Conclusions

The immune function indicators of patients with HIV infection are markedly abnormal, which is mainly manifested by the decreased levels of CD3+, CD4+, CD4+/CD8+, B cells and NK cells, and the increased levels of CD8+. The profile of the immune function indicators correlates with the progressive severity of the disease.

Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-An Extempore Game of Misfiring with Defense Arsenals

The lethal combination involving TB and HIV, known as "syndemic" diseases, synergistically act upon one another to magnify the disease burden. Individuals on anti-retroviral therapy (ART) are at risk of developing TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). The underlying inflammatory complication includes the rapid restoration of immune responses following ART, eventually leading to exaggerated inflammatory responses to MTB antigens. TB-IRIS continues to be a cause of morbidity and mortality among HIV/TB coinfected patients initiating ART, and although a significant quantum of knowledge has been acquired on the pathogenesis of IRIS, the underlying pathomechanisms and identification of a sensitive and specific diagnostic marker still remain a grey area of investigation. Here, we reviewed the latest research developments into IRIS immunopathogenesis, and outlined the modalities to prevent and manage strategies for better clinical and diagnostic outcomes for IRIS.