Dynamics of T-cell subsets and their relationship with oral and systemic opportunistic infections in HIV/AIDS patients during the first year of HAART in Guangxi, China

Abstract

To analyze the dynamic changes in Th1, Th2, Tc1, and Tc2 of HIV/AIDS patients during the first year of highly active antiretroviral therapy (HAART) and to explore their relationship with oral and systemic opportunistic infections, a cohort study was carried out among HIV/AIDS patients in Guangxi, China. Ninety HIV/AIDS patients and 30 healthy controls (HC) were included. The enrolled HIV/AIDS patients were examined at baseline and after 3, 6, and 12 months of HAART. On each visit, oral and systemic opportunistic infections were recorded, oral Candida load and plasma viral load (VL) were counted, differential T-cell counts and flow cytometric analysis of T-cell subsets were performed. During the first year of HAART, the total number of opportunistic infections decreased steadily with the change in oral candidiasis (OC) most representatively. A significant Th1→Th2 switch (Th1/Th2 ratio 0.23 ± 0.12, HC 1.45 ± 0.38) and slight Tc1→Tc2 shift (Tc1/Tc2 ratio 0.93 ± 0.29, HC 1.13 ± 0.33) were found at baseline, and both received slow mitigation after HAART. LgCFU and clinical OC were correlated positively with both LgVL and clinical stage (P < 0.05) at baseline. LgCFU was also correlated positively with clinical stage at all four time points (P < 0.05). In multiple factor analysis, Th1 was confirmed to be correlated negatively with LgVL (Std.B = -0.295, P = 0.025) and LgCFU (Std.B = -0.227, P < 0.001) at baseline. After HAART, LgCFU and clinical stage were only correlated negatively with CD4 when all factors were included. These results suggest that oral candidiasis and oral Candida load could be useful clinical markers in the evaluation of HIV/AIDS patients. Th1 may play an important role against oral and systemic opportunistic infections. Tc1 and Tc2 both showed positive roles in the control of viremia without HAART. J. Med. Virol. 87:1158-1167, 2015. © 2015 Wiley Periodicals, Inc.

Immunological and epidemiological factors affecting candidiasis in HIV patients beginning antiretroviral therapy in an Asian clinic

“…Overall the high burden of candidiasis observed here cannot be attributed solely to defects in the induction of -defensins. A role for systemic defects in T-cell immunity has been argued as there are clear correlations with a Th1 environment (Zhang et al, 2015). This would be consistent with the parallel between susceptibility to Candida and tuberculosis, and by the resolution of most cases of candidiasis on ART.…”

Impact factors of Blastocystis hominis infection in persons living with human immunodeficiency virus: a large-scale, multi-center observational study from China

“…The study demonstrated that increasing VL was independently associated with increased risk, it was consistent with other study [ 44 ]. Furthermore, the study corroborates previous conclusions that HIV VL shows an inverse correlation with CD4 + T cell counts [ 45 ]. HIV infection invades the lymphocytes of the host, leading to compromised immune function and progressive depletion and functional limitations of CD4 + T cells.…”

Salivary human beta‐defensins affected by oral Candida status in Chinese HIV/AIDS patients undergoing ART

“…Opportunistic fungal infections have rapidly emerged as a major driver for mortality in immunocompromised individuals (Brown et al., ). Oral candidiasis is the most common opportunistic fungal infection in HIV‐infected subjects (de Repentigny, Lewandowski, & Jolicoeur, ), especially in patients with CD4 + T cell counts below 200/mm 3 or a high viral load (>3,000 copies/ml) (Jiang et al., ; Tappuni & Fleming, ; Zhang et al., ). In our study, the HIV/AIDS patients were ready to begin ART with low CD4 + T cell counts, which could be the explanation for high prevalence of OC.…”

“…Even though C. albicans is a common component of the oral ecology found in up to 75% of humans (Ghannoum et al, 2010), oral Candida colonization might be associated with low CD4 + T cell counts (Mushi et al, 2017), the failure of ART therapy, systemic opportunistic infections, and malignancies in immunocompromised patients (Delgado et al, 2009;Zhang et al, 2015). In our study, the Candida isolation rates ranged from 63% to 81%, which was similar to those ranging from 56.6% to 82% in previous studies when oral rinse technique was used as the methodology for identifying carrier status (Barchiesi et al, 2002;Campisi, Pizzo, Milici, Mancuso, & Margiotta, 2002;Gottfredsson et al, 1999;Lourenco et al, 2017;Owotade, Patel, Ralephenya, & Vergotine, 2013;Patel et al, 2012;Thanyasrisung et al, 2014).…”