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. 2023 Mar 4;9(3):e14219.
doi: 10.1016/j.heliyon.2023.e14219. eCollection 2023 Mar.

Clinical symptoms and immune injury reflected by low CD4/CD8 ratio should increase the suspicion of HIV coinfection with tuberculosis

Li Li  1   2 , Zulipikaer Abudureheman  3 , XueMei Zhong  1 , Hui Gong  3 , Fan Yang  4 , Abuduweili Awuti  4 , Ayiguli Alimu  3 , Subinuer Yilamujiang  3 , DaYong Zheng  1 , XiaoGuang Zou  1
Affiliations

Clinical symptoms and immune injury reflected by low CD4/CD8 ratio should increase the suspicion of HIV coinfection with tuberculosis

Li Li et al. Heliyon. .

Abstract

Background: Patients who are coinfected with human immunodeficiency virus 1 (HIV) and Mycobacterium tuberculosis (TB) benefit from timely diagnosis and treatment. In the present study frequencies of CD3+, CD4+, and CD8+ T cells among peripheral blood mononuclear cells (PBMCs) of patients in the Kashi region of China infected with HIV, TB, and both HIV and TB (HIV-TB) were investigated to provide a basis for rapid identification of coinfected patients.

Methods: A total of 62 patients with HIV, TB, or HIV-TB who were first hospitalized at our institution were included in the study, as were 30 controls. PBMCs were isolated, and the frequencies of CD3+, CD4+, and CD8+ T cells were determined via flow cytometry.

Results: The frequency of CD4+ T cells and the CD4/CD8 ratio were significantly lower in the HIV-TB group than in the other three groups. In fever patients the frequency of CD4+ T cells and the CD4/CD8 ratio were significantly lower in the HIV-TB group than in the HIV group and the TB group. In patients who exhibited rapid weight loss there were no significant differences in the frequency of CD4+ T cells or the CD4/CD8 ratio between the groups. The results of treatment were compared in the HIV, TB, and HIV-TB groups after 7 days, and there were obvious improvements in the frequency of CD4+ T cells and the CD4/CD8 ratio.

Conclusion: Clinical symptoms and the degree of immune injury can heighten suspicion for HIV-TB coinfection.

Keywords: CD4+ T cells; CD4/CD8 ratio; HIV-TB coinfection.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a Flow cytometry analysis of CD3+, CD4+, and CD8+ T cells. b Frequencies of CD3+, CD4+, and CD8+ T cells in each group. Notes: Δ compared with the control group; * compared with the HIV group; ΔP < 0.05, ΔΔP < 0.01,ΔΔΔP < 0.001; *P < 0.05.
Fig. 1
Fig. 1
a Flow cytometry analysis of CD3+, CD4+, and CD8+ T cells. b Frequencies of CD3+, CD4+, and CD8+ T cells in each group. Notes: Δ compared with the control group; * compared with the HIV group; ΔP < 0.05, ΔΔP < 0.01,ΔΔΔP < 0.001; *P < 0.05.
Fig. 2
Fig. 2
a Flow cytometry analysis of fever patients. b Frequency of CD4+ T cells and the CD4/CD8 ratio in fever patients. Notes: * compared with the HIV group; *p < 0.05; **p < 0.01.
Fig. 3
Fig. 3
a Flow cytometry analysis of patients with rapid weight loss. b Frequency of CD4+ T cells and the CD4/CD8 ratio in patients with rapid weight loss. Notes: * compared with the HIV group; *p < 0.05.
Fig. 4
Fig. 4
a Flow cytometry analysis in patients without fever or rapid weight loss. b Frequency of CD4+ T cells and the CD4/CD8 ratio in patients without fever or rapid weight loss. Notes: * compared with the HIV group; *p < 0.05; **p < 0.01.
Fig. 5
Fig. 5
a Flow cytometry analysis of patients before treatment. b Frequency of CD4+ T cells and the CD4/CD8 ratio in patients before treatment. Notes: * compared with the HIV group; *p < 0.05; **p < 0.01.
Fig. 6
Fig. 6
a Flow cytometry analysis in patients after treatment. b Frequency of CD4+ T cells and the CD4/CD8 ratio in patients after treatment. Notes: * compared with the HIV group; *p < 0.05; **p < 0.01.
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