{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T19:00:29Z","timestamp":1773255629685,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T00:00:00Z","timestamp":1584576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There are limited data on immune restoration of young adults living with virologically suppressed human immunodeficiency virus (HIV). We investigated recovery rates of CD4\/CD8 ratio among Thai children and adolescents after they initiated combination antiretroviral therapy (cART).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Children and adolescents who started cART at age of\u2005\u2265\u20055 years were eligible in this study if they achieved HIV RNA\u2009&amp;lt;\u200950 copies\/mL and had a CD4\/CD8 ratio\u2005&amp;lt;\u20050.8 at the time of virological suppression. Normalization of CD4\/CD8 ratio was defined as 2 consecutive values\u2005\u2265\u20051. Using group-based trajectory analysis, low- and high-recovery groups were identified in terms of CD4\/CD8 ratio recovery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One hundred thirty-eight children and adolescents (101 perinatally infected and 37 behaviorally infected) with median age of 10.6 years at cART treatment initiation were included. After 559 person-years of follow-up (PYFU), overall incidence rate of CD4\/CD8 ratio normalization was 4.1 (95% confidence interval, 2.7\u20136.2) per 100 PYFU. The probabilities of normalization at 2, 5, and 10 years after HIV suppression were 5.2%, 22.6%, and 35.6%, respectively. The low-recovery group had lower median pre-cART CD4 count (146 vs 304 cells\/\u03bcL, P\u2005=\u2005.01), pre-cART CD4\/CD8 ratio (0.15 vs 0.23, P\u2005=\u2005.03) and at first viral suppression (0.38 vs 0.65, P\u2005=\u2005.0001), compared to the high-recovery group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Less than half of children and adolescents living with HIV on cART with viral suppression had CD4\/CD8 ratio normalization. Those with older age at cART initiation, lower pre-cART CD4 count, or CD4\/CD8 ratio had slower ratio recovery. Long-term prognoses such as ongoing immune activation and clinical outcomes among children and adolescents on suppressive cART without CD4\/CD8 ratio normalization need to be further investigated.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jpids\/piaa020","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T20:14:38Z","timestamp":1582661678000},"page":"88-96","source":"Crossref","is-referenced-by-count":7,"title":["CD4\/CD8 Ratio Recovery of Children and Adolescents Living With HIV With Virological Suppression: A Prospective Cohort Study"],"prefix":"10.1093","volume":"10","author":[{"given":"Win Min","family":"Han","sequence":"first","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanakorn","family":"Apornpong","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8796-8238","authenticated-orcid":false,"given":"Ryan","family":"Handoko","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Watsamon","family":"Jantarabenjakul","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"},{"name":"Center of Excellence in Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sivaporn","family":"Gatechompol","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasiwimol","family":"Ubolyam","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen J","family":"Kerr","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anchalee","family":"Avihingsanon","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiat","family":"Ruxrungtham","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Praphan","family":"Phanuphak","sequence":"additional","affiliation":[{"name":"The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand"},{"name":"PREVENTION, Thai Red Cross AIDS Research Centre, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanyawee","family":"Puthanakit","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 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