Viral coinfections and checkpoint-marker expression in HIV: An exploratory HCV-Related CD4⁺ T-Cell PD-L1 pattern

Chronic viral coinfections may contribute to persistent immune dysregulation in people with HIV, but their association with PD-1/PD-L1 expression remains uncertain. We analysed 100 people with HIV using available-case endpoint analyses and marker-specific paired baseline-to-follow-up analyses. Follow-up was scheduled at 12 months (allowable window, 9-15 months), and all participants had HIV RNA < 50 copies/mL at the endpoint. Baseline HBV contact, HCV status, and CMV IgG serostatus were evaluated in relation to PD-1 and PD-L1 expression on CD4⁺ T cells and CD19⁺ B cells and exploratory composite checkpoint-expression indices. HBV contact and CMV IgG serostatus were not associated with reproducible differences. The global comparison of longitudinal CD4⁺ T-cell PD-L1 change across HCV groups did not remain significant after false-discovery-rate correction; an exploratory pairwise comparison suggested a greater increase in participants with baseline HCV RNA positivity. Overall, the HCV-related pattern was hypothesis-generating and requires prospective validation.