The enhanced importance of CD4+ T cell based monitoring of microbial flora in patients with HIV

Abstract

Individuals infected with human immunodeficiency virus (HIV) frequently display diminished CD4 + T Cell levels, heightening susceptibility to diverse infections and imposing substantial burdens alongside life-threatening risks. This study aimed to compare lung microbial communities between general infections and HIV-associated cases. Bronchoalveolar lavage fluid (BALF) samples from 220 patients with lung diseases or infection underwent 16S ribosomal RNA (16S rRNA) and internal transcribed spacer (ITS) sequencing analysis. The cohort comprised with 18 HIV-negative, galactomannan (GM) assay testing-negative (HNGN) individuals; 29 HIV-negative, GM-positive (HNGP) individuals; 103 HIV-positive, GM-negative (HPGN) individuals; and 70 HIV-positive, GM-positive (HPGP) individuals. Through comparative analysis of microbial disparities across groups, we observed that GM test-positive individuals displayed pronounced fungal infections, which significantly amplified the detectable diversity of fungal species while exhibiting heterogeneous compositional profiles. Conversely, bacterial diversity demonstrated negligible overall variation. Notably, viral load exhibited an inverse correlation with CD4 + T Cell counts, and these immune cells further revealed a discernible association with both viral load dynamics and microbial community shifts. These insights underscore the critical necessity for real-time monitoring of CD4 + T Cell fluctuations and microbial equilibrium in clinical infected patients.