To explore the difference of peripheral immune indexes especially T subsets cell mitochondrial indexes in patients with chronic HBV infection (CHB), liver cirrhosis (LC), hepatocellular carcinoma (HCC) and healthy controls (HCs). From May 2023 to December 2023, HBV infected patients aged 40–59 years (HBV infection group, 236 cases) and healthy people of the same age group (control group, 112 cases) were selected as the study objects. More than 80 parameters related to lymphocyte including cell percentage, absolute count, mitochondrial mass and mitochondrial low membrane potential were obtained by flow cytometry. The mitochondrial mass of memory T cells was found to be sequentially raised in the disease progression of hepatitis B patients from CHB to LC and eventually to HCC, and mitochondrial low membrane potential ratio was sequentially decreased. Then we screened out 4 main indicators related to the stage of disease progression in HBV-infected patients and distinguished the differences among the control group, CHB, LC, and HCC groups through the calculation of MPOLS (mitochondrial parameters of lymphocyte subsets) value, which can be used as a novel biomarker for hepatitis B disease progression. Mitochondrial parameters of peripheral lymphocytes in HBV-infected patients are significant indicators of different stages of disease progression. The MPOLS provides rich clinical data support for clinical early warning of high-risk hepatitis B patients, and we believe that the MPOLS can be combined with a variety of clinical characteristics to achieve more accurate diagnosis and treatment.

Among hospitalized severely immunocompromised persons with HIV (PWH), non-tuberculous mycobacteria (NTM) may be under-diagnosed due to non-specific symptoms undifferentiable with other opportunistic infections. To evaluate the prevalence of NTM mycobacteremia and how screening for mycobacteremia assistant with identification of NTM infections, this study retrospectively analyzed 1,136 hospitalized PWH with CD4 counts <200 cells/μL, who underwent mycobacteremia screening at a tertiary hospital in Nanjing, China, between July 2018 and December 2023. The prevalence of non-tuberculous mycobacteremia was 5.8% (95% CI, 4.6–7.3%), with a higher prevalence of 8.6% (95% CI, 6.7–10.9%) in patients with CD4 counts <50 cells/μL, compared to 1.4% (95% CI, 0.6–3.0%) in those with CD4 counts ≥50 cells/μL. Mycobacterium avium complex (MAC) was the predominant pathogen, representing 95% (95% CI, 86.7–98.3%) of positive blood cultures, though it accounted for only 66.2% (95% CI, 54.3–76.3%) of NTM species isolated from respiratory samples. The sensitivity of mycobacterial blood cultures (MBC) in diagnosing all culture-proven NTM infections was 63.9% (95% CI, 54.0–72.8%), increasing to 75.7% (95% CI, 64.8–84.0%) in patients with CD4 counts <50 cells/μL. Notably, mycobacteremia served as the sole microbiological evidence in approximately 25% of all culture-proven NTM infections during initial hospitalization, where other specimen sources failed to yield conclusive evidence. These findings underscore the importance of mycobacteremia screening in improving the detection of NTM infections among severely immunocompromised hospitalized patients, especially those with CD4 counts <50 cells/μL, and highlight the value of incorporating MBC into diagnostic protocols to enhance clinical management of these high-risk individuals.

Yi-Fan Hu, Shun-Xin Li, Hong-Li Liu, Zhi-Xiang Du, Shuang-Shuang Wang, Miao-Yang Chen, Li Wang, Qing-Fang Xiong, Yan-Dan Zhong, Du-Xian Liu, Yong-Feng Yang. Gut and Liver 2024;18:867-76. https://doi.org/10.5009/gnl230468