HIV-MTB Co-Infection Reduces CD4+ T Cells and Affects Granuloma Integrity
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics
2.2. Study Subjects and Data Collection
2.3. Specimen Collection
2.4. Case Definition
2.5. Histopathological Study
2.6. Granuloma Morphology HE Staining Microscopy
- Typical granulomas composed of epithelioid cells, multinucleated giant cells, macrophages, surrounding lymphocytes, and reactive proliferating fibroblasts forming a nodular structure with a clear boundary and no caseous necrosis at the center.
- Caseous necrotic granulomas (typical tuberculous granulomas) with complete coagulative necrosis (visually caseous necrosis) at the center of the granuloma.
- Fibrous granulomas mainly evolved from typical granulomas, predominantly composed of fibroblasts and fibrocytes, with a few epithelioid cells and macrophages [13];
2.7. Immunohistochemical Tests
2.8. Quantitative Analysis of Immunohistochemistry
2.9. Statistical Analysis
3. Results
3.1. General Information
3.2. Pathological Findings
3.2.1. HIV Infection Reduced the Integrity of Granulomas
3.2.2. The Integrity of Tuberculous Granulomas in HIV-MTB Co-Infected Individuals Was Positively Correlated with Peripheral Blood CD4+ T Cell Count
3.3. Immunohistochemistry Results
3.3.1. HIV-MTB Co-Infection Leads to a Reduction in T Lymphocytes in Granulomatous Tissues
3.3.2. The Integrity of Tuberculous Granulomas in Co-Infected Patients Was Positively Correlated with the Proportion of CD4+ T Cells and CD3+ T Cells in Granulomatous Tissues
3.3.3. The Count of Peripheral Blood CD4+ T Cells Was Positively Correlated with the Proportion of CD4+ T Cells in Granulomatous Tissues in Co-Infected Patients
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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Group | Average Age (Years) | Gender | Biopsy Site | ||
---|---|---|---|---|---|
Male | Female | Pulmonary | Extrapulmonary | ||
HIV-MTB co-infection (n = 53) | 41.40 (±13.74) | 42 | 11 | 5 | 48 |
MTB mono-infection (n = 49) | 27.71 (±20.04) | 21 | 28 | 5 | 44 |
Subject No. | ART before Biopsy | Biopsy Site | Biopsy Anti-Fast Bacilli Staining | Treatment Regimens of TB before Biopsy |
---|---|---|---|---|
1 | - | Neck (mass) | (−) | - |
2 | - | Neck (mass) | (+) | - |
3 | 3TC + TDF + EFV | Neck (LN) | (+) | - |
4 | 3TC + TDF + EFV | Neck (LN) | (+) | HRZE |
5 | - | Neck (LN) | (+) | - |
6 | 3TC + TDF + EFV | Groin (LN) | - | |
7 | - | Neck (mass) | (+) | - |
8 | - | Neck (mass) | (+) | - |
9 | - | Neck (mass) | (−) | - |
10 | 3TC + TDF + EFV | Lung (mass) | (+) | - |
11 | 3TC + TDF + EFV | Neck (LN) | (+) | - |
12 | - | Abdominal cavity (LN) | (+) | - |
13 | 3TC + TDF + EFV | Abdominal cavity (LN) | (+) | HEZMfx + LZD |
14 | - | Mandible (LN) | (+) | HRZE |
15 | 3TC + TDF + EFV | Neck (LN) | (+) | HRZELfx |
16 | 3TC + TDF + EFV | Retroperitoneal (LN) | (+) | HRZE |
17 | 3TC + TDF + EFV | Mediastinum (LN) | (+) | RfbLfx |
18 | No detailed regimen | Neck (LN) | (+) | - |
19 | 3TC + TDF + LPV/r | Axilla (LN) | (+) | HREMfx |
20 | No detailed regimen | Adrenal gland | (−) | HRZE |
21 | 3TC + EFV + LPV/r | Neck (mass) | (−) | RftEMfx |
22 | TDF + FTC + DTG | Lung (mass) | (+) | HRZE |
23 | 3TC + EFV + LPV/r | Abdominal cavity (mass) | (+) | Mfx + CLI + LZD |
24 | FTC + DTG | Abdominal wall (mass) | (+) | HRZE |
25 | 3TC + TDF + RAL | Abdominal cavity (mass) | (+) | - |
26 | 3TC + TDF + EFV | Lung (mass) | (+) | - |
27 | TDF + FTC + DTG | Neck (LN) | (+) | HRZE |
28 | 3TC + TDF + RAL | Mandible (LN) | (+) | - |
29 | TDF + FTC + DTG | Neck (LN) | (+) | HRfbZ |
30 | No detailed regimen | Neck (LN) | (+) | HREZLfx |
31 | 3TC + TDF + EFV | Lung (mass) | (+) | HRZEMfx |
32 | - | Neck (mass) | (+) | - |
33 | 3TC + TDF + EFV | Neck (LN) | (+) | HRZE |
34 | 3TC + TDF + EFV | Neck (LN) | (+) | - |
35 | 3TC + TDF + EFV | Abdominal cavity (mass) | (−) | - |
36 | 3TC + TDF + EFV | Mandible (mass) | (+) | HRZELfx |
37 | 3TC + TDF + EFV | Neck (mass) | (−) | - |
38 | 3TC + TDF + EFV | Chest wall (mass) | (−) | RfbEPto |
39 | 3TC + AZT + LPV/r | Neck (LN) | (+) | - |
40 | 3TC + EFV + AZT | Neck (LN) | (+) | - |
41 | 3TC + TDF + EFV | Pelvic cavity (mass) | (+) | RE |
42 | - | Posterior auricular LN | (+) | - |
43 | 3TC + TDF + EFV | Lung (mass) | (+) | PaELfx |
44 | unknown | Kidney (mass) | (−) | unknown |
45 | unknown | Neck (mass) | (+) | unknown |
46 | unknown | Liver (mass) | (+) | unknown |
47 | - | Neck (mass) | (−) | - |
48 | 3TC + EFV + ABC | Neck (LN) | (+) | - |
49 | - | Liver (mass) | (−) | - |
50 | - | Groin (LN) | (−) | - |
51 | unknown | Chest wall (mass) | unknown | |
52 | TDF + FTC + DTG | Arm (mass) | (+) | - |
53 | unknown | Neck (LN) | (+) | unknown |
Subject No. | Biopsy Site | Biopsy Anti-Fast Bacilli Staining | Treatment Regimens of TB before Biopsy |
---|---|---|---|
1 | Axilla (LN) | (+) | unknown |
2 | Axilla (mass) | (+) | - |
3 | Neck (LN) | (+) | - |
4 | Paraspinal (mass) | (−) | HRftELfx |
5 | Neck (LN) | (−) | HRZ |
6 | Neck (LN) | (−) | - |
7 | Neck (LN) | (+) | - |
8 | Neck (LN) | (+) | HRZE |
9 | Neck (LN) | (+) | - |
10 | Abdominal wall (mass) | (+) | HRZE |
11 | Chest wall (mass) | (+) | HRZ |
12 | Neck (LN) | (+) | - |
13 | Pleura | (+) | HRZE |
14 | Neck (LN) | (+) | HRZE |
15 | Chest wall (mass) | (−) | HRZE |
16 | Neck (LN) | (+) | - |
17 | Neck (LN) | (−) | - |
18 | Neck (LN) | (+) | - |
19 | Lung (mass) | (+) | HRZE |
20 | Pelvic cavity (mass) | (+) | HRZE |
21 | Neck (LN) | (−) | - |
22 | Neck (LN) | (−) | PaRftLfx |
23 | Neck (LN) | (+) | - |
24 | Neck (LN) | (−) | HRZMfx |
25 | Paraspinal (mass) | (+) | HRZE |
26 | Chest wall (mass) | (+) | HRZE |
27 | Neck (LN) | (+) | HRZE |
28 | Abdominal cavity (mass) | (−) | HRE + LZD + Am |
29 | Neck (LN) | (+) | HRZE |
30 | Axilla (mass) | (+) | HRZE |
31 | Neck (LN) | (+) | HRZE |
32 | Neck (LN) | (−) | HRZE |
33 | Psoas major muscle (mass) | (−) | HRZE |
34 | Neck (LN) | (+) | - |
35 | Neck (LN) | (−) | HRE |
36 | Neck (LN) | (−) | - |
37 | Chest wall (mass) | (+) | PAS + HRZ |
38 | Neck (LN) | (+) | HRZE |
39 | Neck (LN) | (−) | HRZE |
40 | Neck (LN) | (+) | - |
41 | Abdominal cavity (mass) | (+) | HRZMfx |
42 | Neck (LN) | (+) | - |
43 | Neck (LN) | (−) | - |
44 | Knee joint (mass) | (+) | - |
45 | Lung (mass) | (−) | unknown |
46 | Hip joint (mass) | (+) | - |
47 | Lung (mass) | (+) | HRZE |
48 | Neck (LN) | (+) | - |
49 | Axilla (mass) | (+) | - |
Variable | Group | Wald | p | OR | 95% CI for OR |
---|---|---|---|---|---|
Gender | Male | ||||
Female | 2.125 | 0.145 | 7.848 | 0.492–125.245 | |
Biopsy site | Pulmonary | 2.852 | 0.091 | 0.129 | 0.012–1.389 |
Extrapulmonary | |||||
CD4+ T cell count in peripheral blood (/mm3) | 4.493 | 0.034 | 0.995 | 0.991–1.000 | |
Monocyte proportion in peripheral blood (%) | 2.261 | 0.133 | 1.136 | 0.962–1.342 |
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Huang, S.; Liu, M.; Zhang, H.; Song, W.; Guo, W.; Feng, Y.; Ma, X.; Shi, X.; Liu, J.; Liu, L.; et al. HIV-MTB Co-Infection Reduces CD4+ T Cells and Affects Granuloma Integrity. Viruses 2024, 16, 1335. https://doi.org/10.3390/v16081335
Huang S, Liu M, Zhang H, Song W, Guo W, Feng Y, Ma X, Shi X, Liu J, Liu L, et al. HIV-MTB Co-Infection Reduces CD4+ T Cells and Affects Granuloma Integrity. Viruses. 2024; 16(8):1335. https://doi.org/10.3390/v16081335
Chicago/Turabian StyleHuang, Suyue, Maoying Liu, Hui Zhang, Wei Song, Wenjuan Guo, Yanling Feng, Xin Ma, Xia Shi, Jianjian Liu, Li Liu, and et al. 2024. "HIV-MTB Co-Infection Reduces CD4+ T Cells and Affects Granuloma Integrity" Viruses 16, no. 8: 1335. https://doi.org/10.3390/v16081335