Decreased CD8+ T Lymphocytes is an Independent Influencing Factor for Persistent HR-HPV Infection.

OBJECTIVE

To explore the characteristics of vaginal microecological changes and peripheral blood immune cell subset levels in patients with high-risk human papillomavirus (HR-HPV) infection, and to identify independent risk factors for persistent HR-HPV infection, so as to provide a reference for clinical prevention and treatment of cervical lesions.

METHODS

A total of 165 participants admitted to Ningde Mindong Hospital from January 2021 to December 2022 were enrolled in this single-center observational study, including 49 cases with persistent HR-HPV positivity and 116 cases with transient HR-HPV infection. Vaginal microecological indicators (cleanliness, pH, bacterial vaginosis score, hydrogen peroxide, sialidase) and peripheral blood immune cell subsets were detected to analyse.

RESULTS

Compared with the transient HR-HPV infection group, the persistent infection group showed significant vaginal microecological imbalance, including lower proportion of grade I-II vaginal cleanliness, higher BV score ≥4, lower proportion of pH ≤4.5, and higher positive rates of hydrogen peroxide and sialidase (all P<0.05). In addition, in the present study, sialidase was also significantly increased in the group with cytological and pathological results ≥HSIL (P<0.05). The percentages of CD4+ T lymphocytes and CD8+ T lymphocytes in the persistent infection group were significantly decreased (P<0.05), while there were no significant differences in T lymphocytes, B lymphocytes, and NK cells between the two groups (P>0.05). Multivariate Logistic regression analysis showed that decreased CD8+ T lymphocytes was an independent risk factor for persistent HR-HPV infection (P<0.05).

CONCLUSION

Persistent HR-HPV infection is closely associated with vaginal microecological imbalance and impaired cellular immune function. This exploratory study confirms that decreased CD8+ T lymphocytes is independently associated with persistent HR-HPV infection. Comprehensive assessment of vaginal microecological status and CD8+ T lymphocyte level may help identify high-risk populations, but the clinical predictive value needs to be verified by large-sample prospective studies.