{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:58:22Z","timestamp":1775455102096,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012542","name":"Sichuan Provincial Science and Technology Support Program","doi-asserted-by":"publisher","award":["2024NSFSC1747"],"award-info":[{"award-number":["2024NSFSC1747"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to characterize long\u2010term immune reconstitution trajectories and influencing factors in people living with HIV exhibiting suboptimal early immune responses after 24\u2009months of antiretroviral therapy (ART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective multicentre study from January 2016 to October 2024. Eligible participants achieved sustained virological suppression within six months of ART but maintained CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts &lt;350 cells\/\u03bcL at 24\u2009months. Demographic and clinical characteristics were analysed, and Cox regression models were used to identify factors associated with different long\u2010term immune reconstitution patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 5272 virologically suppressed individuals, 348 were included in the final analysis. The median age was 48\u2009years (IQR 38.0\u201357.0), and the median duration of ART was 4.5\u2009years (IQR 4.0\u20136.0). The overall median CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts increased gradually during the first four years after ART initiation, followed by an annual growth &lt;10 cells\/\u03bcL thereafter. Three distinct immune recovery trajectories were identified: progressively increasing (37.1%), minor fluctuating (56.9%) and progressively declining (6.0%). Among the increasing group, 62.0% eventually achieved immune reconstitution. Cox regression analysis showed that baseline CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cell counts \u2265200 cells\/\u03bcL were strongly associated with successful long\u2010term immune reconstitution (HR\u2009=\u20091.9, 95% CI: 1.2\u20132.9), whereas transient viremia increased the risk of both fluctuating (HR\u2009=\u20092.3, 95% CI: 1.2\u20134.8) and declining trajectories (HR\u2009=\u20092.5, 95% CI: 1.1\u20136.0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      People living with HIV with suboptimal early immune responses exhibit three distinct immune recovery trajectories. Higher baseline CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cell levels favour long\u2010term reconstitution, whereas transient viremia may predict persistent immune failure.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70192","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T04:21:06Z","timestamp":1767673266000},"page":"607-615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term immune reconstitution patterns and influencing factors in people living with\n                    <scp>HIV<\/scp>\n                    exhibiting suboptimal immune response after 24\u2009months of antiretroviral therapy"],"prefix":"10.1111","volume":"27","author":[{"given":"Liting","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Hematology\u2010Oncology Chongqing University Cancer Hospital, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment  Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Tuo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naijuan","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiju","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuqiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingxiang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Sichuan Provincial People's Hospital University of Electronic Science and Technology  Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fujie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical and Research Center for Infectious Diseases, Beijing Ditan Hospital Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"UNAIDS.Global HIV & AIDS statistics \u2013 2024 fact sheet.https:\/\/www.unaids.org\/en\/resources\/fact-sheet"},{"issue":"1","key":"e_1_2_12_3_1","first-page":"16","article-title":"The prevalence of HIV\u2010infected patients with Virological suppression but a CD4(+) T\u2010cell count of \u2264200 cells\/mm(3) after highly active antiretroviral therapy initiation: a meta\u2010analysis","volume":"24","author":"Wu Z","year":"2022","journal-title":"AIDS Rev"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60604-8"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1269650"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2025.2539198"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1535565"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002157"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148915"},{"issue":"23","key":"e_1_2_12_10_1","first-page":"9647","article-title":"The pattern and magnitude of T cell subsets reconstitution during ten years of ART with viral suppression in HIV\u2010infected patients","volume":"14","author":"Lu L","year":"2022","journal-title":"Aging (Albany NY)"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0240880"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001848"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217742"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13707"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1152951"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2025.105667"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1086\/649215"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000003383"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.24543"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac762"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200209270-00002"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/597093"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2020.1840928"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002248"},{"issue":"1","key":"e_1_2_12_25_1","first-page":"3","article-title":"Consensus on diagnosis and management of immunological non\u2010responder in acquired immunodeficiency syndrome (version 2023)","volume":"42","author":"Acquired Immunodeficiency Syndrome and Hepatitis C Professional Group, Society of Infectious Diseases, Chinese Medical Association","year":"2024","journal-title":"Chin J Infect Dis"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25585"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2019.07.037"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2017.08.001"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002010"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001913"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1466655"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-12-322453"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/515962"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103306"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.663843"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70192","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70192","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:09:40Z","timestamp":1775452180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":34,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/hiv.70192"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70192","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]},"assertion":[{"value":"2025-11-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}