In multivariable Cox regression, IL-6/IFN-γ ratio >4.0 (HR 4.12, 95% CI 1.86-9.14), CD4+ <200 cells/μL (HR 3.24, 95% CI 1.58-6.64), and APRI >1.0 (HR 2.86, 95% CI 1.34-6.11) independently predicted progression, whilst preserved T-cell polyfunctionality was protective (HR 0.32, 95% CI 0.15-0.68).<h4>Conclusions</h4>HIV-HBV coinfection was characterized by HBV reactivation, cytokine imbalance, and T-cell exhaustion, which were associated with disease progression and may inform risk stratification. This evidence concerns the gene CD4 and coinfection.