Efficient T cell compartment in HIV+ patients receiving orthotopic liver transplant and immunosuppressive therapy.J Infect Dis. 2020 Jul 04 [Online ahead of print]JI
BACKGROUND AND AIMS
In patients undergoing orthotopic liver transplant (OLT), immunosuppressive (IS) treatment is mandatory and infections are leading causes of morbidity/mortality. Thus, it is essential to understand the functionality of cell-mediated immunity after OLT. The aim of the study was to identify changes in T cell phenotype and polyfunctionality in HIV+ and HIV- patients treated with IS after OLT.
We studied peripheral blood mononuclear cells from 108 subjects divided in 4 groups of 27: HIV+ transplanted patients; HIV- transplanted patients; HIV+ non-transplanted patients; healthy subjects. T cell activation, differentiation and cytokine production were analyzed by flow cytometry.
Median age was 55 years (52-59), median CD4 count in HIV+ patients was 567 cells/mL, all had undetectable viral load. CD4+ and CD8+ T cell subpopulations showed different distributions between HIV+ and HIV- OLT patients. A cluster representing effector cells expressing PD1 was abundant in HIV- transplanted patients and they were characterized by higher levels of CD4+ T cells able to produce IFN-g and TNF-a.
HIV- transplanted patients have more exhausted or inflammatory T cells compared to HIV+ transplanted patients, suggesting that patients who already experienced a form of immunosuppression due to HIV infection respond differently to anti-rejection therapy.