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

Li Li; Zulipikaer Abudureheman; XueMei Zhong; Hui Gong; Fan Yang; Abuduweili Awuti; Ayiguli Alimu; Subinuer Yilamujiang; DaYong Zheng; XiaoGuang Zou

doi:10.1016/j.heliyon.2023.e14219

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

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

Authors

Affiliations

¹ Department of Respiratory and Critical Care Medicine, First People's Hospital of Kashi, Kashi, China.
² State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, China.
³ Department of Clinical Research Center of Infectious Diseases (Pulmonary Tuberculosis), First People's Hospital of Kashi, Kashi, China.
⁴ Department of Infectious Diseases, First People's Hospital of Kashi, Kashi, China.

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.