Immunological profiles of HIV-positive recipients of liver transplant

• Published in: Transplant immunology Vol. 57; p. 101208
• Main Authors: Righi, Elda, Ivaldi, Federico, La Rosa, Alessandro, Carnelutti, Alessia, Londero, Angela, Bassetti, Matteo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2019
• Subjects: B cells; B-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - immunology; Coinfection; Female; Graft Rejection - immunology; Healthy controls; Hepacivirus - physiology; Hepatitis C - immunology; HIV Antibodies - blood; HIV Infections - immunology; HIV-1 - physiology; HIV-positive; Humans; Immune Tolerance; Immunologic Memory; Killer Cells, Natural - immunology; Liver transplant recipients; Liver Transplantation; Male; Middle Aged; NK cells; RNA, Viral - genetics; T regulatory cells; T-Lymphocytes, Regulatory - immunology; Transplant Recipients; Healthy controls; HIV-positive; NK cells; B cells; T regulatory cells; Liver transplant recipients
• ISSN: 0966-3274; 1878-5492; 1878-5492
• DOI: 10.1016/j.trim.2019.05.001

Scarce data are available about immune cell frequencies in HIV-positive recipients of liver transplant. Alterations in immune subsets can lead to persistent immune activation and disease progression or reduced HIV-specific responses. In liver transplantation, impaired immune tolerance can lead to organ rejection. HIV-positive subjects with undetectable HIVRNA and CD4 > 100/mm3 were included. Control groups were non-transplanted HIV-positive patients with similar immunovirological parameters and healthy subjects. B cells (memory, transitional, and mature subsets), T cells (effector TH1, nonclassic TH1, TH17, TH1/17; T regulatory naïve and effector subsets and CD8+ T regulatory cells), and NK cells (CD56dim and CD56bright subsets) were analyzed by flow cytometry. A total of 56 patients, including 14 HIV-positive transplant recipients (HIV-LT), 14 HIV-positive controls, and 28 healthy controls were included. Median age of HIV-LT patients was 54.9 years with median time from transplant of 7.6 years. Eleven (79%) were HIV/HCV coinfected. Compared to nontransplanted patients, HIV-LT displayed significantly increased frequency of T CD8+ cells, lower percentage of T CD4+ cell, and lower number of nonclassic TH1, TH1/17 cells and naïve T CD4+ regulatory cells (Tregs). Healthy controls showed increased numbers of B cell subsets and decreased percentage of T effector subpopulations compared to HIV-LT. Compared to HIV-positive patients, healthy controls had higher B cells, NK cells, CD4+ T cells, naïve CD4+ Tregs but lower CD8+ T cells, effector Tregs, CD8+ Tregs, and all T effector cell subsets. Immune cell subpopulations potentially associated with HIV progression and organ rejection were detected in HIV-positive transplant recipients. We confirmed altered frequencies of B, T, and NK cell populations in HIV-positive liver transplant recipients compared to healthy controls. The imbalance among immune cell subsets deserves further studies to identify markers of transplant outcome and potential therapeutic targets. •Limited data are available about immune profiles in HIV-positive recipients of liver transplant (HIV-LT)•Healthy controls showed increased numbers of B cell subsets and decreased T effector subpopulations compared to HIV-LT.•Altered frequencies of B, T, and NK cell populations were shown in HIV-LT compared to healthy controls.•Knowledge of immune cell proportions may help stratify HIV-LT requiring additional monitoring after transplantation