Van der Mescht, Mieke AdriSteel, Helen CarolynDe Beer, ZeldaMasenge, AndriesAbdullah, FareedUeckermann, VeronicaAnderson, RonaldRossouw, Theresa M.2025-02-172025-02-172024-11Van der Mescht, M.A.; Steel, H.C.; de Beer, Z.; Masenge, A.; Abdullah, F.; Ueckermann, V.; Anderson, R.; Rossouw, T.M. T-Cell Phenotypes and Systemic Cytokine Profiles of People Living with HIV Admitted to Hospital with COVID-19. Microorganisms 2024, 12, 2149. https://DOI.org/10.3390/microorganisms12112149.2076-260710.3390/microorganisms12112149http://hdl.handle.net/2263/100975DATA AVAILABILITY STATEMENT : The raw data supporting the conclusions of this article will be made available by the authors on request.Whether SARS-CoV-2 infection leads to a higher mortality and morbidity in people living with HIV (PLWH) in Africa remains inconclusive. In this study, we explored the differences in the T-cell phenotypes between people with and without HIV on the day of admission (V1) and ±7 days later (V2), as well as their cytokine/chemokine profiles on V1. Patients admitted with COVID-19 were recruited between May 2020 and December 2021 from the Steve Biko Academic and Tshwane District Hospitals in Pretoria, South Africa. Of 174 patients, 37 (21%) were PLWH. T-cell profiles were determined by flow cytometry, and cytokine levels were determined using a multiplex suspension bead array. PLWH were significantly younger than those without HIV, and were more likely to be female. In an adjusted analysis, PLWH had higher percentages of CD4+ central memory (CM) programmed cell death protein 1 (PD-1)+, CD8+ effector memory (EM)2, and CD8+ EM4 CD57+ cells, as well as higher concentrations of interleukin (IL)-35 at admission. PLWH with CD4+ T-cell counts of >200 cells/mm3 had altered CD4+ and CD8+ T-cell profiles, lower levels of systemic inflammation measured by plasma ferritin and PCT levels, and less severe disease. PLWH with CD4+ T-cell counts of <200 cells/mm3 on admission had higher concentrations of IL-6 and lower levels of IL-29. At V2, the percentages of CD4+ CM PD-1+ T-cells and CD8+ EM4 T-cells co-expressing CD57 and PD-1 remained higher in PLWH, while all other CD8+ EM populations were lower. Fewer CD8+ EM-cells after ±7 days of admission may be indicative of mechanisms inhibiting EM T-cell survival, as indicated by the higher expression of IL-35 and the T-cell maturation arrest observed in PLWH. This profile was not observed in PLWH with severe immunodeficiency, highlighting the need for differentiated care in the broader PLWH population.en© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and onditions of the Creative Commons Attribution (CC BY) license.T-cellsCytokinesSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Coronavirus disease 2019 (COVID-19)COVID-19 pandemicHuman immunodeficiency virus (HIV)People living with HIV (PLHIV)SDG-03: Good health and well-beingArticle