Med. 2026 May 15. pii: S2666-6340(26)00146-7. [Epub ahead of print]
101143
ANRS-MIE CO21 CODEX study group
BACKGROUND: NKG2A+CD8+ T cells are unconventional T cells described in the context of various diseases. However, their role remains poorly understood. People living with HIV-2 (PLWH2), unlike people living with HIV-1 (PLWH1), exhibit minimal intestinal inflammation despite continuous viral replication in the absence of antiretroviral treatment, but the mechanisms underlying this protection are unknown.
METHODS: We characterized NKG2A+ and NKG2C+ CD8+ T cells from PLWH1 and PLWH2 with distinctive clinical phenotypes using spectral flow cytometry. Their functional response was evaluated using target cells, polyclonal T cell receptor activation, and cytokine stimulations. Cellular and plasma markers of gut mucosal integrity, T cell activation, and systemic inflammation were quantified.
FINDINGS: NKG2A+ and NKG2C+ CD8+ T cells demonstrated stronger responsiveness to stimulation than conventional CD8+ T cells. NKG2A+CD8+ T cells frequently expressed regulatory molecules, homing receptors, and interleukin-22 (IL-22). The frequencies of NKG2A+ and NKG2C+ CD8+ T cells were increased in PLWH2 compared to PLWH1. They more frequently expressed DNAM-1 (CD226), CCR5, and CD49d. NKG2A+CD8+ T cells from PLWH2 correlated with gut integrity (CD4+ T helper 17/regulatory T cell ratio) and reduced chronic immune activation. PLWH2 displayed lower levels of plasma biomarkers of inflammation, gut integrity, and IL-23, but higher levels of IL-15 compared to PLWH1. IL-15 promoted the functional activity of NKG2A+CD8+ T cells and enhanced their expression of CD39 and DNAM-1.
CONCLUSIONS: Our findings suggest that NKG2A+CD8+ T cells contribute to the maintenance of gut homeostasis and low systemic inflammation in PLWH2.
FUNDING: This work was funded by Sidaction, ANRS-MIE, Institut Pasteur, and the MESRI (France).
Keywords: HIV controllers; HIV-1; HIV-2; IL-15; IL-22; NKG2A(+)CD8(+) T cells; NKG2C(+)CD8(+) T cells; translation to patients; unconventional T cells