Authors
Brian Eka Rachman, Yehuda Tri Nugroho Supranoto, Fitri Revita Nurannisa, Siti Mei Saroh, Siti Qamariyah Khairunisa, Citrawati Dyah Kencono Wungu, Dian Paramita Kartikasari, Nasronudin Nasronudin, Masanori Kameoka, Muhammad Miftahussurur, Retno Pudji Rahayu, Afif Nurul Hidayati
Published in
PloS one. Volume 21. Issue 10. Pages e0358793. Epub Oct 12, 2026.
Abstract
Immunological Nonresponse (INR) in people living with HIV (PLWH) is characterized by inadequate CD4+ T-cell recovery despite effective viral suppression through antiretroviral therapy (ART). This systematic review and meta-analysis identify key clinical, demographic, and molecular predictors of INR to optimize immune recovery strategies. A comprehensive literature search was conducted in accordance with PRISMA 2020 guidelines, yielding 59 eligible studies, with a total of 19,511 individuals with INR. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and pooled effect estimates were calculated as odds ratio (OR), mean difference (MD), or standardized mean difference (SMD). Significant predictors of INR included male sex [OR 1.33 (1.12-1.58)], older age [MD 2.61 (1.42-3.81)], intravenous drug use [OR 1.67 (1.15-2.42)], hepatitis B coinfection [OR 1.30 (1.08-1.57)], hepatitis C coinfection [OR 1.85 (1.50-2.28)], tuberculosis [OR 1.77 (1.41-2.21)], advanced HIV stage [OR 2.66 (2.34-3.02)], and lower baseline and nadir CD4+ counts [SMD -3.82 (-4.94-(-2.70)), SMD -1.69 (-2.69-(-0.68))], respectively. Additionally, 57 biomarkers were identified as potential predictors of INR, implicating several immunological pathways. These findings underscore the multifactorial nature of INR and the need for personalized approaches among ART-treated individuals.
PMID:
42862878
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.
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