ArticleBMC infectious diseases2026
Dysfunction of circulating follicular helper T cells in people living with HIV who are HBV small surface protein antibody (HBsAb)-negative despite HBV vaccination.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe seroconversion rate after hepatitis B virus (HBV) vaccination in people living with human immunodeficiency virus (HIV) is reportedly lower than that in non-HIV controls. Follicular helper T (Tfh) cells play a central role in humoral immunity, and IL-21 secreted by Tfh cells is essential for B cells to differentiate into plasma cells. This study investigated the frequency and function of circulating Tfh (cTfh) cells isolated from people living with HIV (PWH) who are negative for hepatitis B virus (HBV) surface antigen (HBsAb-) in a small cohort of PWH who received HBV vaccination. CASE PRESENTATION: The frequency of cTfh cells in HBsAb- PWH (HBsAb levels less than 10 mIU/mL) was the same as that in non-HIV controls and HBsAb positive (HBsAb+) PWH, who maintained HBsAb at 10 mIU/mL for at least 1 year after receiving three doses of the HBV vaccine. However, after immune stimulation with anti-CD3/CD28 antibodies, the frequency of cTfh cells in the non-HIV controls and HBsAb+ PWH increased, whereas the frequency of cTfh cells in the HBsAb- PWH tended to be more gradual. cTfh17-like and cTfh2-like cells, subsets of cTfh cells, are involved in humoral immunity, and PD-1 regulates the function of these cells in the germinal center. The frequencies of PD-1+ cTfh17-like and cTfh2-like cells at baseline did not differ significantly among the three groups. However, HBsAb- PWH had a lower frequency of PD-1+ cTfh17-like cells after immune stimulation than non-HIV controls did. The frequencies of PD-1+ cTfh17-like cells and cTfh2-like cells with high PD-1 expression were significantly lower in HBsAb- PWH than in non-HIV controls. Furthermore, the production of IL-21, which is essential for plasma cell differentiation, tended to be lower in HBsAb- PWH than in non-HIV controls or HBsAb+ PWH.
conclusionscTfh cells isolated from HBsAb- PWH may be unable to produce sufficient IL-21 after immune stimulation. This study is the first to suggest that cTfh cells may not function adequately in some PWH. This study highlights the need for large-scale validation of cTfh cell frequency and function in PWH. CLINICAL TRIAL NUMBER: Not applicable.
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