{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:54:34Z","timestamp":1791266074795,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":277,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Treatment"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living with HIV (PLWHA) may experience increased vulnerability to SARS\u2010CoV\u20102 infection and severe COVID\u201019 due to immune dysregulation, comorbidities, and treatment adherence challenges. Kenya has over 1.4 million PLWHA. However, only a few have been reported with severe COVID\u201019, suggesting potential protective roles of antiretroviral therapy (ART), management of comorbidities, and COVID\u201019 vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted across high HIV\u2010prevalence regions in Kenya (Nakuru, Malindi\/Mariakani, and Kisumu). A cross\u2010sectional survey evaluates clinical characteristics and self\u2010reported COVID\u201019 vaccination outcomes among 303 PLWHA. Quantitative data were collected through structured questionnaires and clinical records. Associations between ART, immune markers (CD4\/CD8 counts; viral load), COVID\u201019 vaccination, and SARS\u2010CoV\u20102 infection and severity were tested using Chi\u2010square and Fisher\u2019s exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      An analysis of 303 participants (70.6% female, median age 40) revealed an 86.5% COVID\u201019 vaccination rate and 94.1% ART adherence. Only 9.2% reported prior SARS\u2010CoV\u20102 infection, mostly mild, potentially indicating underreporting or asymptomatic cases. Interestingly, missing ART doses were significantly associated with contracting SARS\u2010CoV\u20102 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03). Furthermore, all participants reporting or demonstrating SARS\u2010CoV\u20102 infection were vaccinated, compared to 85.1% of uninfected participants (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014). Due to incomplete health records, data for CD4 counts were available for only 7.6% of participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923), limiting conclusions regarding immune dysregulation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low COVID\u201019 rates were observed. All cases occurred in vaccinated participants, likely reflecting health\u2010seeking bias rather than vaccine failure. Missing ART doses were significantly associated with infection. Optimal risk mitigation requires integrated strategies prioritizing both high vaccine coverage and strict ART adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/arat\/5621772","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:27:13Z","timestamp":1791264433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Antiretroviral Therapy, Immune Dysregulation, and COVID\u201019 Vaccination on SARS\u2010CoV\u20102 Outcomes in PLWHA in Kenya"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1462-2057","authenticated-orcid":false,"given":"James Kinoti","family":"Njue","sequence":"first","affiliation":[{"name":"School of Medicine Moi University  Eldoret Kenya  mu.ac.ke"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihana","family":"Wekesa","sequence":"additional","affiliation":[{"name":"Centre for Virus Research (CVR) Kenya Medical Research Institute (KEMRI)  Nairobi Kenya  kemri.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Maiyo","sequence":"additional","affiliation":[{"name":"Centre for Virus Research (CVR) Kenya Medical Research Institute (KEMRI)  Nairobi Kenya  kemri.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zakayo Maingi","family":"Mwangi","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science Meru University of Technology  Meru Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Kagendo","sequence":"additional","affiliation":[{"name":"School of Nursing and Public Health Chuka University  Chuka Kenya  chuka.ac.ke"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5877-1367","authenticated-orcid":false,"given":"Raphael Mwamtsi","family":"Lwembe","sequence":"additional","affiliation":[{"name":"Centre for Virus Research (CVR) Kenya Medical Research Institute (KEMRI)  Nairobi Kenya  kemri.org"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13754"},{"key":"e_1_2_13_2_2","volume-title":"WHO\u2019s Response to Health Emergencies: Annual Report 2023","author":"World Health Organization","year":"2024"},{"key":"e_1_2_13_3_2","volume-title":"Coronavirus Disease (COVID-19)","author":"World Health Organization","year":"2020"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874613601610010034"},{"key":"e_1_2_13_5_2","volume-title":"The Urgency of Now: AIDS at a Crossroads","year":"2024"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.2196\/53409"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30464-5"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1198"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0126-2024"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1605"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.4081\/jphia.2023.2658"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/ebm.2024.10059"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/M20-3689"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiab114"},{"key":"e_1_2_13_15_2","article-title":"COVID-19 Vaccine Hesitancy Among People Living With HIV in Sub-Saharan Africa: A Systematic Review","volume":"11","author":"Liu X.","year":"2023","journal-title":"Vaccines (Basel)"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18073554"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1693903"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.11604\/PHCP.2026.5.2.48248"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1758852"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2352-3018(22)00097-2"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.01.007"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-022-00618-w"},{"key":"e_1_2_13_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2023-012581"},{"key":"e_1_2_13_24_2","first-page":"21","article-title":"Immunogenicity of mRNA Vaccination Against SARS-CoV-2 in Persons Living With HIV (PLWHs) With Low CD4 Count or Previous AIDS","volume":"22","author":"Antinori A.","year":"2021","journal-title":"HIV Medicine"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/jvi.00688-25"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001007"},{"key":"e_1_2_13_27_2","unstructured":"YousifM. 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