Xiaowu Wang, Xiaoyu Fang, Tuantuan Li, Xinqi Geng, Yan Liu, Shuheng Wang, Dong Wu, Yilang Zhu, Linding Wang
KSHV seropositivity correlates with impaired immune reconstitution in virally suppressed PWH. CD4+ and IL-6 may jointly serve as a screening tool for KSHV serostatus assessment, though their utility for detecting active infection requires further study.
BACKGROUND: Kaposi's sarcoma-associated herpesvirus (KSHV) seropositivity is prevalent in people with HIV (PWH), yet its association with immune reconstitution during long-term ART remains unclear.
METHODS: In this retrospective cohort study, we reviewed the records of 209 virally suppressed PWH (VL < 50 copies/mL) after ≥ 2 years of ART. Participants were stratified based on their KSHV serostatus (IgG+). Data on immune parameters were extracted from laboratory reports corresponding to the 2-year post-ART time point.
RESULTS: KSHV seropositive individuals exhibited significantly lower CD4+ counts (101.5 vs. 316.0 cells/μL; p < 0.001), reduced CD4/CD8 ratios (0.26 vs. 0.60; p < 0.001), and elevated IL-6 (9.78 vs. 5.46 pg/mL; p < 0.001). Multivariate analysis identified IL-6 as an independent predictor of seropositivity (OR = 1.238; p < 0.001). The combination of CD4+ (≤ 126 cells/μL) and IL-6 (> 5.83 pg/mL) showed superior diagnostic accuracy for KSHV seropositivity (AUC = 0.832).
CONCLUSION: KSHV seropositivity correlates with impaired immune reconstitution in virally suppressed PWH. CD4+ and IL-6 may jointly serve as a screening tool for KSHV serostatus assessment, though their utility for detecting active infection requires further study.