HIV–Tuberculosis Coinfection Reshapes CD4⁺ T-Cell Differentiation Trajectories and Associates with Adrenal Hormonal Imbalance
Abstract
Abstract Background: HIV–tuberculosis (TB) co-infection is associated with profound immune dysregulation, but how it affects CD4 + T-cell differentiation and its relationship with adrenal hormonal imbalance remains incompletely understood. We characterized naïve and effector/memory CD4 + T-cell profiles across the spectrum of HIV-associated TB and investigated the differentiation of Mycobacterium tuberculosis ( Mtb )-responsive CD4 + T cells and their modulation by dehydroepiandrosterone (DHEA) in vitro . Results: In this cross-sectional study, 88 individuals were classified as HIV-TB, HIV-TB with immune reconstitution inflammatory syndrome, HIV with latent TB, HIV without TB, or healthy donors. HIV-TB and immune reconstitution inflammatory syndrome showed a marked redistribution of the CD4 + T-cell compartment, characterized by reduced naïve and increased effector-memory cells, together with lower naïve-to-effector-memory ratios. Preservation of the naïve compartment was positively associated with CD4 + T-cell counts, CD4/CD8 ratio, and adrenal hormone parameters, whereas central memory cells showed associations with DHEA and cortisol/DHEA ratios. Mtb -responsive CD4 + T cells from HIV-TB individuals showed reduced central memory and increased terminally differentiated effector-memory cells compared with total CD4 + T cells, whereas healthy donors displayed a broader differentiation shift following Mtb stimulation. Correlation analyses revealed distinct differentiation…
How strong is the evidence?
Evidence Hub reads this as a preprint, done in cell cultures (in vitro), not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 88 participants or records.
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