Objective  To investigate the correlation of T lymphocyte subsets, including CD3⁺T lymphocytes, CD4⁺T lymphocytes and CD8⁺T lymphocytes, CD19⁺B lymphocytes, and natural killer (NK) cell levels with the prognosis of patients with high-risk human papillomavirus (HR-HPV) infection.

Methods A total of 210 patients with cervical HR-HPV infection admitted to Guangzhou Red Cross Hospital from January 2021 to February 2022 were retrospectively selected. According to the outcome of HR-HPV infection during two years of follow-up, the patients were divided into a negative group (n = 94) and a positive group (n = 116). Another 90 patients with cervical HR-HPV infection admitted between March 2022 and January 2023 were selected as the validation set. Univariate and multivariate stepwise Logistic regression analyses were used to analyze the effects of various factors on HR-HPV outcomes. A nomogram for the probability of HR-HPV clearance in patients with cervical HR-HPV infection was constructed based on the outcomes after 24 months of follow-up. Receiver operating characteristic (ROC) curves were used to evaluate the value of combined immune cell prediction, clinical indicators, and the Logistic model in relation to HR-HPV outcomes. Calibration curves and decision curve analysis (DCA) were used to evaluate the predictive performance and clinical application value of the Logistic model, which was further validated in the validation set.

Results Age, history of vaginal microecological abnormality, HPV infection type, cervical cytology results, CD3⁺ T lymphocytes, CD4⁺ T lymphocytes, CD8⁺ T lymphocytes, CD19⁺ B lymphocytes, and NK cells were factors associated with the 24-month prognosis of patients with HR-HPV infection (all P ＜ 0.05). The area under the curve (AUC) of the Logistic model was higher than that of the model containing only clinical features, indicating that immunological indicators could improve the predictive performance for the outcome of HR-HPV infection. The Logistic model showed good calibration and clinical benefit in both the training set and the validation set.

Conclusions CD3⁺ T lymphocytes, CD4⁺ T lymphocytes, CD8⁺ T lymphocytes, CD19⁺ B lymphocytes, and NK cells are factors associated with the outcome of cervical HR-HPV infection.