背景:尽管性激素被认为可以诱导免疫变异,激素疗法对免疫力的影响知之甚少。这里,我们量化了激素治疗对感染HIV的顺式女性(CW)、跨性别女性和非二元人群(TNBP)中HIV-1免疫标志物的影响.
方法:我们考虑了来自顺式男性(CM)的CD4,CD8和淋巴细胞测量值,瑞士HIV队列研究中的CW和TNBP。我们使用线性混合效应模型对HIV-1标记进行建模,并在“性别”(CW,TNBP)和“激素治疗使用”(是/否)。模型根据年龄进行了调整,种族,教育水平,自开始抗逆转录病毒治疗和使用静脉注射药物以来的时间。我们使用92种炎症标记物的血清蛋白质组学测量,评估了31种TNBP激素治疗的炎症作用。
结果:我们包括了来自3092CW和83TNBP的54083次测量,和147230测量从8611厘米。与CW相比,使用激素疗法增加了TNBP中的CD4计数和CD4:CD8比率(p相互作用分别为0.02和0.007)。使用激素治疗的TNBP具有显著较高的CD4计数[中位数=772细胞/μL,四分位数间距(IQR):520-1006]比没有(617个细胞/μL,426-892)。这类似于CW与CM对CD4T细胞的作用。激素疗法的使用不会影响TNBP中的血清蛋白浓度。
结论:这项研究强调了激素疗法在调节免疫系统等生物和社会因素中的潜在作用。特别是在TNBP与艾滋病毒。
BACKGROUND: Although sex hormones are recognized to induce immune variations, the effect of hormonal therapy use on immunity is only poorly understood. Here, we quantified how hormonal therapy use affects HIV-1 immune markers in cis women (CW) and trans women and non-binary people (TNBP) with HIV.
METHODS: We considered CD4, CD8 and lymphocyte measurements from cis men (CM), CW and TNBP in the Swiss HIV Cohort Study. We modelled HIV-1 markers using linear mixed-effects models with an interaction between \'gender\' (CW, TNBP) and \'hormonal therapy use\' (yes/no). Models were adjusted on age, ethnicity, education level, time since start of antiretroviral therapy and use of intravenous drugs. We assessed the inflammatory effect of hormonal therapy use in 31 TNBP using serum proteomics measurements of 92 inflammation markers.
RESULTS: We included 54 083 measurements from 3092 CW and 83 TNBP, and 147 230 measurements from 8611 CM. Hormonal therapy use increased CD4 count and CD4:CD8 ratio in TNBP more than in CW (pinteraction = 0.02 and 0.007, respectively). TNBP with hormonal therapy use had significantly higher CD4 counts [median = 772 cells/μL, interquartile range (IQR): 520-1006] than without (617 cells/μL, 426-892). This was similar to the effect of CW versus CM on CD4 T cells. Hormonal therapy use did not affect serum protein concentrations in TNBP.
CONCLUSIONS: This study highlights the potential role of hormonal therapy use in modulating the immune system among other biological and social factors, especially in TNBP with HIV.