{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:45:47Z","timestamp":1770756347690,"version":"3.50.0"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100010438","name":"The Francis Crick Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010438","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virol J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>The West African HIV\/AIDS epidemic, historically driven by HIV-1 CRF02_AG, other recombinant forms and HIV-2, remains less researched for various preventive and therapeutic interventions. We established the <jats:bold>\n                <jats:underline>W<\/jats:underline>\n              <\/jats:bold>ACCBIP long-term <jats:bold>\n                <jats:underline>H<\/jats:underline>\n              <\/jats:bold>IV <jats:bold>\n                <jats:underline>I<\/jats:underline>\n              <\/jats:bold>nfection <jats:bold>\n                <jats:underline>C<\/jats:underline>\n              <\/jats:bold>o<jats:bold>\n                <jats:underline>h<\/jats:underline>\n              <\/jats:bold>ort (WHICH Study) to investigate the dynamics of HIV epidemic in Ghana. This report evaluates viral load dynamics, immune responses, and organ-level metabolic changes following antiretroviral therapy (ART) initiation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>We collected blood samples, medical, and demographic data from ART-na\u00efve individuals at baseline and six months post-ART, and from ART-experienced individuals at a single time point. Participants, aged 10 years and above, were purposively enrolled from six health facilities. Laboratory analyses included viral load, CD4 and CD8 counts, co-infection screening (hepatitis B\/C, syphilis), liver and kidney function tests, haemoglobin estimation, and HIV-1\/2 typing. Chi-square and logistic regression analyses were used to assess associations between participant demographics and clinical data with uncontrolled viremia and immune recovery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 426 participants were recruited, comprising 159 ART-na\u00efve and 267 ART-experienced individuals, with a mean age of 41.5 years. Median ART duration for ART-experienced was greater than 5 years. Infections included HIV-1 (78.6%), HIV-2 (2.1%), and dual HIV-1&amp;2 (19.2%). Common comorbidities were anaemia (54.9%), hepatitis B (9.5%), and hypertension (8.2%). Most participant (97.9%) were on dolutegravir-anchored regimen. Among ART-na\u00efve individuals, median viral load decreased from log<jats:sub>10<\/jats:sub> 5.16 at baseline to log<jats:sub>10<\/jats:sub> 4.64 copies\/mL after six months (<jats:italic>p<\/jats:italic>\u2009=\u20090.0156). Median viral load for the ART-experienced arm was log<jats:sub>10<\/jats:sub> 3.23 copies\/mL. Median CD4 count increased from 290 cells\/mm\u00b3 in ART-na\u00efve participants to 504 cells\/mm\u00b3 at six-months post-ART (<jats:italic>p<\/jats:italic>\u2009=\u20090.0003) and 581 cells\/mm\u00b3 in ART-experienced participants (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). ART-na\u00efve participants were 19 times more likely to have unsuppressed viral loads at baseline compared to ART-experienced participants. ARTna\u00efve- participants had significantly decreased odds of immune recovery (aOR\u2009=\u20090.35, 95% CI: 0.140\u20130.85, <jats:italic>p<\/jats:italic>\u2009=\u20090.021), as did those with low CD4\/CD8 ratio (aOR\u2009=\u20090.06, 95% CI: 0.02\u20130.20; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Kidney function and haemoglobin levels were significantly improved six-month post-ART among the ART-na\u00efve group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study highlights the significant reduction in viral load and improved immune recovery following ART initiation despite uncontrolled viremia in a subset of participants. This cohort presents an opportunity to study Ghana\u2019s local HIV epidemic, including HIV-1 and HIV-2, and impact of ART on disease progression.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12985-025-02873-w","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T09:23:50Z","timestamp":1752917030000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Slow virologic control but strong immune and metabolic recovery with dolutegravir-anchored therapy in an HIV cohort in Ghana"],"prefix":"10.1186","volume":"22","author":[{"given":"Mark","family":"Appeaning","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin","family":"Magomere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberta Mawulawoe","family":"Abotsi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana Ama Yeboaa","family":"Amoako","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirk Elorm","family":"Kouffie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Becky Ewurama","family":"Tetteh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bridget Nana Darkoa","family":"Quist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christ\u00e8le Nguepou","family":"Tchopba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria Akosua","family":"Ansa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn Yayra","family":"Bonney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Kojo","family":"Quashie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,19]]},"reference":[{"key":"2873_CR1","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.ijid.2020.09.011","volume":"100","author":"Y Assefa","year":"2020","unstructured":"Assefa Y, Gilks CF. Ending the epidemic of HIV\/AIDS by 2030: will there be an endgame to HIV, or an endemic HIV requiring an integrated health systems response in many countries? Int J Infect Dis. 2020;100:273\u20137.","journal-title":"Int J Infect Dis"},{"key":"2873_CR2","unstructured":"World Health Organization. The role of HIV viral suppression in improving individual health and reducing transmission: policy brief. World Health Organization; 2023."},{"issue":"6","key":"2873_CR3","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1093\/cid\/ciq248","volume":"52","author":"OT Campbell-Yesufu","year":"2011","unstructured":"Campbell-Yesufu OT, Gandhi RT. Update on human immunodeficiency virus (HIV)-2 infection. Clin Infect Dis. 2011;52(6):780\u20137.","journal-title":"Clin Infect Dis"},{"key":"2873_CR4","doi-asserted-by":"crossref","unstructured":"Giovanetti M, Ciccozzi M, Parolin C, Borsetti A. Molecular epidemiology of HIV-1 in African countries: A comprehensive overview. Pathogens [Internet]. 2020; 9(12).","DOI":"10.3390\/pathogens9121072"},{"issue":"1","key":"2873_CR5","doi-asserted-by":"publisher","first-page":"128","DOI":"10.3390\/v15010128","volume":"15","author":"A Appah","year":"2022","unstructured":"Appah A, Beelen CJ, Kirkby D, Dong W, Shahid A, Foley B, et al. Molecular epidemiology of HIV-1 in ghana: subtype distribution, drug resistance and coreceptor usage. Viruses. 2022;15(1):128.","journal-title":"Viruses"},{"issue":"6","key":"2873_CR6","doi-asserted-by":"publisher","first-page":"3163","DOI":"10.1128\/JVI.03353-14","volume":"89","author":"PK Quashie","year":"2015","unstructured":"Quashie PK, Oliviera M, Veres T, Osman N, Han Y-S, Hassounah S, et al. Differential effects of the G118R, H51Y, and E138K resistance substitutions in different subtypes of HIV integrase. J Virol. 2015;89(6):3163\u201375.","journal-title":"J Virol"},{"key":"2873_CR7","doi-asserted-by":"crossref","unstructured":"Ndung\u2019u T, Dong KL, Kwon DS, Walker BD. A FRESH approach: combining basic science and social good. Sci Immunol. 2018;3(27).","DOI":"10.1126\/sciimmunol.aau2798"},{"key":"2873_CR8","unstructured":"Ghana AIDS. Commission. Ghana\u2019s HIV Fact Sheet 2019. 2020."},{"key":"2873_CR9","unstructured":"Ghana Health Service. Consolidated guidelines for HIV care in Ghana. 2019."},{"key":"2873_CR10","unstructured":"World Health Organization. Consolidated guidelines on HIV testing services, 2019. Consolidated guidelines on HIV testing services, 20192020."},{"issue":"1","key":"2873_CR11","doi-asserted-by":"publisher","first-page":"e0279900","DOI":"10.1371\/journal.pone.0279900","volume":"18","author":"E Ambaye","year":"2023","unstructured":"Ambaye E, Ormago MD, Ali MM. Sero-prevalence and associated factors of sexually transmitted infections among youth-friendly services attendees. PLoS ONE. 2023;18(1):e0279900.","journal-title":"PLoS ONE"},{"issue":"2","key":"2873_CR12","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1053\/j.ajkd.2021.08.003","volume":"79","author":"C Delgado","year":"2022","unstructured":"Delgado C, Baweja M, Crews DC, Eneanya ND, Gadegbeku CA, Inker LA, et al. A unifying approach for GFR estimation: recommendations of the NKF-ASN task force on reassessing the inclusion of race in diagnosing kidney disease. Am J Kidney Dis. 2022;79(2):268\u2013e881.","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"2873_CR13","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1097\/QAI.0000000000000214","volume":"66","author":"D Wade","year":"2014","unstructured":"Wade D, Daneau G, Aboud S, Vercauteren GH, Urassa WS, Kestens L. WHO multicenter evaluation of facscount CD4 and Pima CD4 T-cell count systems: instrument performance and misclassification of HIV-infected patients. J Acquir Immune Defic Syndr. 2014;66(5):e98\u2013107.","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2873_CR14","unstructured":"World Bank. Survey solutions CAPI\/CAWI platform: release 24.06. The World Bank Washington DC; 2018."},{"issue":"11","key":"2873_CR15","doi-asserted-by":"publisher","first-page":"e0142515","DOI":"10.1371\/journal.pone.0142515","volume":"10","author":"K Jansen","year":"2015","unstructured":"Jansen K, Thamm M, Bock C-T, Scheufele R, K\u00fccherer C, Muenstermann D, et al. High prevalence and high incidence of coinfection with hepatitis B, hepatitis C, and syphilis and low rate of effective vaccination against hepatitis B in HIV-Positive men who have sex with men with known date of HIV seroconversion in Germany. PLoS ONE. 2015;10(11):e0142515.","journal-title":"PLoS ONE"},{"key":"2873_CR16","doi-asserted-by":"publisher","first-page":"e46750","DOI":"10.2196\/46750","volume":"10","author":"R Yang","year":"2024","unstructured":"Yang R, Yuan R, Gui X, Ke H, Zhuang K, Hu H, et al. Characteristics of hepatitis B virus, hepatitis C virus, and syphilis coinfection in people with HIV\/AIDS contracted through different sources: retrospective study. JMIR Public Health Surveillance. 2024;10:e46750.","journal-title":"JMIR Public Health Surveillance"},{"issue":"1","key":"2873_CR17","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/1471-2458-13-38","volume":"13","author":"F Mosha","year":"2013","unstructured":"Mosha F, Muchunguzi V, Matee M, Sangeda RZ, Vercauteren J, Nsubuga P, et al. Gender differences in HIV disease progression and treatment outcomes among HIV patients one year after starting antiretroviral treatment (ART) in Dar Es salaam, Tanzania. BMC Public Health. 2013;13(1):38.","journal-title":"BMC Public Health"},{"key":"2873_CR18","doi-asserted-by":"crossref","unstructured":"Oguntibeju O. Quality of life of people living with HIV and AIDS and antiretroviral therapy. HIV\/AIDS - Research and Palliative Care. 2012;117.","DOI":"10.2147\/HIV.S32321"},{"issue":"3","key":"2873_CR19","doi-asserted-by":"publisher","first-page":"220","DOI":"10.4103\/1947-2714.109196","volume":"5","author":"B Achappa","year":"2013","unstructured":"Achappa B, Madi D, Bhaskaran U, Ramapuram JT, Rao S, Mahalingam S. Adherence to antiretroviral therapy among people living with HIV. N Am J Med Sci. 2013;5(3):220\u20133.","journal-title":"N Am J Med Sci"},{"issue":"3","key":"2873_CR20","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1258\/095646203762869160","volume":"14","author":"D Gisselquist","year":"2003","unstructured":"Gisselquist D, Potterat JJ. Heterosexual transmission of HIV in africa: an empiric estimate. Int J STD AIDS. 2003;14(3):162\u201373.","journal-title":"Int J STD AIDS"},{"issue":"10279","key":"2873_CR21","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/S0140-6736(21)00321-4","volume":"397","author":"KH Mayer","year":"2021","unstructured":"Mayer KH, Nelson L, Hightow-Weidman L, Mimiaga MJ, Mena L, Reisner S, et al. The persistent and evolving HIV epidemic in American men who have sex with men. Lancet. 2021;397(10279):1116\u201326.","journal-title":"Lancet"},{"issue":"11","key":"2873_CR22","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1089\/apc.2010.0371","volume":"25","author":"M Liao","year":"2011","unstructured":"Liao M, Kang D, Jiang B, Tao X, Qian Y, Wang T, et al. Bisexual behavior and infection with HIV and syphilis among men who have sex with men along the East Coast of China. AIDS Patient Care STDs. 2011;25(11):683\u201391.","journal-title":"AIDS Patient Care STDs"},{"key":"2873_CR23","doi-asserted-by":"publisher","first-page":"102255","DOI":"10.1016\/j.eclinm.2023.102255","volume":"65","author":"M Moyo-Chilufya","year":"2023","unstructured":"Moyo-Chilufya M, Maluleke K, Kgarosi K, Muyoyeta M, Hongoro C, Musekiwa A. The burden of non-communicable diseases among people living with HIV in Sub-Saharan africa: a systematic review and meta-analysis. eClinicalMedicine. 2023;65:102255.","journal-title":"eClinicalMedicine"},{"issue":"6","key":"2873_CR24","doi-asserted-by":"publisher","first-page":"e07172","DOI":"10.1016\/j.heliyon.2021.e07172","volume":"7","author":"TB Kwofie","year":"2021","unstructured":"Kwofie TB, Adigbli D, Osei-Yeboah J, Ativi E, Lokpo SY. Hepatitis B and C infections in HIV-1 patients on combination antiretroviral therapy (cART) in ghana: implications for Immunologic recovery, clinical response to treatment, and hepatotoxicity. Heliyon. 2021;7(6):e07172.","journal-title":"Heliyon"},{"key":"2873_CR25","doi-asserted-by":"crossref","unstructured":"Pappoe F, Hagan CKO, Obiri-Yeboah D, Nsiah P. Sero-prevalence of hepatitis B and C viral infections in Ghanaian HIV positive cohort: a consideration for their health care. BMC Infect Dis. 2019;19(1).","DOI":"10.1186\/s12879-019-4027-y"},{"key":"2873_CR26","doi-asserted-by":"publisher","first-page":"232595822110224","DOI":"10.1177\/23259582211022469","volume":"20","author":"K Torpey","year":"2021","unstructured":"Torpey K, Ogyiri L, Cuylaerts V, Agyeman S, Agyei-Nkansah A, Buyze J, et al. Hepatitis C prevalence and validation of a clinical prediction score for targeted screening among people living with HIV in Ghana. J Int Association Providers AIDS Care (JIAPAC). 2021;20:232595822110224.","journal-title":"J Int Association Providers AIDS Care (JIAPAC)"},{"issue":"7","key":"2873_CR27","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/S1473-3099(15)00485-5","volume":"16","author":"L Platt","year":"2016","unstructured":"Platt L, Easterbrook P, Gower E, Mcdonald B, Sabin K, Mcgowan C, et al. Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. Lancet Infect Dis. 2016;16(7):797\u2013808.","journal-title":"Lancet Infect Dis"},{"key":"2873_CR28","doi-asserted-by":"publisher","unstructured":"Pansue K, Promsena P, Songtaweesin WN, et al. High prevalence of hepatitis C virus infection among adolescents and young adults attending HIV and sexual health clinics. Int. J. STD AIDS. 2024;36(4):289\u201396. https:\/\/doi.org\/10.1177\/09564624241302231","DOI":"10.1177\/09564624241302231"},{"issue":"3","key":"2873_CR29","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1097\/QAD.0000000000002753","volume":"35","author":"K Hughes","year":"2021","unstructured":"Hughes K, Chang J, Stadtler H, Wyatt C, Klotman M, Blasi M. HIV-1 infection of the kidney: mechanisms and implications. Aids. 2021;35(3):359\u201367.","journal-title":"Aids"},{"issue":"1","key":"2873_CR30","doi-asserted-by":"publisher","first-page":"e23","DOI":"10.1016\/S2352-3018(15)00211-8","volume":"3","author":"A Mocroft","year":"2016","unstructured":"Mocroft A, Lundgren JD, Ross M, Fux CA, Reiss P, Moranne O, et al. Cumulative and current exposure to potentially nephrotoxic antiretrovirals and development of chronic kidney disease in HIV-positive individuals with a normal baseline estimated glomerular filtration rate: a prospective international cohort study. Lancet HIV. 2016;3(1):e23\u201332.","journal-title":"Lancet HIV"},{"issue":"1","key":"2873_CR31","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/1423-0127-16-102","volume":"16","author":"C Obirikorang","year":"2009","unstructured":"Obirikorang C, Yeboah FA. Blood haemoglobin measurement as a predictive indicator for the progression of HIV\/AIDS in resource-limited setting. J Biomed Sci. 2009;16(1):102.","journal-title":"J Biomed Sci"},{"issue":"8","key":"2873_CR32","doi-asserted-by":"publisher","first-page":"e0272405","DOI":"10.1371\/journal.pone.0272405","volume":"17","author":"L Frescura","year":"2022","unstructured":"Frescura L, Godfrey-Faussett P, Feizzadeh AA, El-Sadr W, Syarif O, Ghys PD. Achieving the 95 95 95 targets for all: A pathway to ending AIDS. PLoS ONE. 2022;17(8):e0272405.","journal-title":"PLoS ONE"},{"key":"2873_CR33","doi-asserted-by":"crossref","unstructured":"Gebremedhin T, Aynalem M, Adem M, Geremew D, Aleka Y, Kiflie A. Dolutegravir based therapy showed CD4\u2009+\u2009T cell count recovery and viral load suppression among ART Na\u00efve people living with HIV AIDS: a pilot evaluation. Sci Rep. 2024;14(1).","DOI":"10.1038\/s41598-024-53282-y"},{"issue":"1","key":"2873_CR34","doi-asserted-by":"publisher","first-page":"32947","DOI":"10.1038\/srep32947","volume":"6","author":"M Hoenigl","year":"2016","unstructured":"Hoenigl M, Chaillon A, Moore DJ, Morris SR, Mehta SR, Gianella S, et al. Rapid HIV viral load suppression in those initiating antiretroviral therapy at first visit after HIV diagnosis. Sci Rep. 2016;6(1):32947.","journal-title":"Sci Rep"},{"issue":"2","key":"2873_CR35","doi-asserted-by":"publisher","first-page":"e0000080","DOI":"10.1371\/journal.pgph.0000080","volume":"2","author":"AD Haas","year":"2022","unstructured":"Haas AD, Radin E, Birhanu S, Low AJ, Saito S, Sachathep K, et al. Prevalence of and factors associated with late diagnosis of HIV in malawi, zambia, and zimbabwe: results from population-based nationally representative surveys. PLOS Global Public Health. 2022;2(2):e0000080.","journal-title":"PLOS Global Public Health"},{"issue":"11","key":"2873_CR36","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1089\/aid.2010.0333","volume":"27","author":"NMC V\u00e9ras","year":"2011","unstructured":"V\u00e9ras NMC, Santoro MM, Gray RR, Tatem AJ, Presti AL, Olearo F, et al. Molecular epidemiology of HIV type 1 CRF02_AG in Cameroon and African patients living in Italy. AIDS Res Hum Retroviruses. 2011;27(11):1173\u201382.","journal-title":"AIDS Res Hum Retroviruses"},{"key":"2873_CR37","doi-asserted-by":"crossref","unstructured":"Casado C, Galvez C, Pernas M, Tarancon-Diez L, Rodriguez C, Sanchez-Merino V et al. Permanent control of HIV-1 pathogenesis in exceptional elite controllers: a model of spontaneous cure. Sci Rep. 2020;10(1).","DOI":"10.1038\/s41598-020-58696-y"},{"issue":"3","key":"2873_CR38","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1007\/s11904-017-0356-x","volume":"14","author":"CO Hileman","year":"2017","unstructured":"Hileman CO, Funderburg NT, Inflammation. Immune activation, and antiretroviral therapy in HIV. Curr HIV\/AIDS Rep. 2017;14(3):93\u2013100.","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2873_CR39","doi-asserted-by":"crossref","unstructured":"Bruzzese E, Lo Vecchio A, Smarrazzo A, Tambaro O, Palmiero G, Bonadies G et al. Dolutegravir-based anti-retroviral therapy is effective and safe in HIV\u2013infected paediatric patients. Ital J Pediatr. 2018;44(1).","DOI":"10.1186\/s13052-018-0469-x"},{"issue":"6","key":"2873_CR40","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1111\/hiv.13467","volume":"24","author":"K Mounzer","year":"2023","unstructured":"Mounzer K, Brunet L, Fusco JS, Mcnicholl IR, Dunbar M, Sension M, et al. Immune response to ART initiation in advanced HIV infection. HIV Med. 2023;24(6):716\u201326.","journal-title":"HIV Med"},{"issue":"1","key":"2873_CR41","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1111\/imr.12064","volume":"254","author":"EMP Wilson","year":"2013","unstructured":"Wilson EMP, Sereti I. Immune restoration after antiretroviral therapy: the pitfalls of hasty or incomplete repairs. Immunol Rev. 2013;254(1):343\u201354.","journal-title":"Immunol Rev"},{"key":"2873_CR42","doi-asserted-by":"crossref","unstructured":"Sun L, Su Y, Jiao A, Wang X, Zhang B. T cells in health and disease. Signal Transduct Target Therapy. 2023;8(1).","DOI":"10.1038\/s41392-023-01471-y"},{"key":"2873_CR43","doi-asserted-by":"crossref","unstructured":"Taramasso L, Labate L, Briano F, Brucci G, Mora S, Blanchi S et al. CD4\u2009+\u2009T lymphocyte recovery in the modern antiretroviral therapy era: toward a new threshold for defining immunological non-responders. Front Virol. 2023;2.","DOI":"10.3389\/fviro.2022.822153"},{"issue":"10","key":"2873_CR44","first-page":"1351","volume":"12","author":"SK Masenga","year":"2023","unstructured":"Masenga SK, Mweene BC, Luwaya E, Muchaili L, Chona M, Kirabo A. HIV\u2013Host Cell Interact Cells. 2023;12(10):1351.","journal-title":"HIV\u2013Host Cell Interact Cells"},{"key":"2873_CR45","doi-asserted-by":"crossref","unstructured":"Abana CZ, Sagoe KWC, Bonney EY, Maina EK, Aziati ID, Agbosu E et al. Drug resistance mutations and viral load in human immunodeficiency virus type 2 and dual HIV-1\/ HIV-2 infected patients in Ghana. Medicine. 2019;98(6).","DOI":"10.1097\/MD.0000000000014313"},{"key":"2873_CR46","doi-asserted-by":"crossref","unstructured":"Deletsu SD, Maina EK, Quaye O, Ampofo WK, Awandare GA, Bonney EY. High resistance to reverse transcriptase inhibitors among persons infected with human immunodeficiency virus type 1 subtype Circulating Recombinant form 02_AG in Ghana and on antiretroviral therapy. Medicine. 2020;99(7).","DOI":"10.1097\/MD.0000000000018777"},{"issue":"4","key":"2873_CR47","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/S1473-3099(13)70692-3","volume":"14","author":"B Grinsztejn","year":"2014","unstructured":"Grinsztejn B, Hosseinipour MC, Ribaudo HJ, Swindells S, Eron J, Chen YQ, et al. Effects of early versus delayed initiation of antiretroviral treatment on clinical outcomes of HIV-1 infection: results from the phase 3 HPTN 052 randomised controlled trial. Lancet Infect Dis. 2014;14(4):281\u201390.","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"2873_CR48","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/COH.0000000000000118","volume":"10","author":"R Rajasuriar","year":"2015","unstructured":"Rajasuriar R, Wright E, Lewin SR. Impact of antiretroviral therapy (ART) timing on chronic immune activation\/inflammation and end-organ damage. Curr Opin HIV AIDS. 2015;10(1):35\u201342.","journal-title":"Curr Opin HIV AIDS"},{"issue":"2","key":"2873_CR49","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/S2055-6640(20)30466-0","volume":"2","author":"S Rangarajan","year":"2016","unstructured":"Rangarajan S, Donn JC, Giang le T, Bui DD, Hung Nguyen H, Tou PB, et al. Factors associated with HIV viral load suppression on antiretroviral therapy in Vietnam. J Virus Erad. 2016;2(2):94\u2013101.","journal-title":"J Virus Erad"},{"issue":"1","key":"2873_CR50","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/hiv.12081","volume":"15","author":"S Serrano-Villar","year":"2014","unstructured":"Serrano-Villar S, Moreno S, Fuentes\u2010Ferrer M, S\u00e1nchez\u2010Marcos C, \u00c1vila M, Sainz T, et al. The CD4:CD8 ratio is associated with markers of age-associated disease in virally suppressed HIV-infected patients with immunological recovery. HIV Med. 2014;15(1):40\u20139.","journal-title":"HIV Med"},{"issue":"4","key":"2873_CR51","first-page":"106","volume":"27","author":"I Sereti","year":"2020","unstructured":"Sereti I. Immune reconstruction inflammatory syndrome in HIV infection: beyond what Meets the eye. Top Antivir Med. 2020;27(4):106\u201311.","journal-title":"Top Antivir Med"}],"container-title":["Virology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12985-025-02873-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12985-025-02873-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12985-025-02873-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T14:40:50Z","timestamp":1757256050000},"score":1,"resource":{"primary":{"URL":"https:\/\/virologyj.biomedcentral.com\/articles\/10.1186\/s12985-025-02873-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,19]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2873"],"URL":"https:\/\/doi.org\/10.1186\/s12985-025-02873-w","relation":{},"ISSN":["1743-422X"],"issn-type":[{"value":"1743-422X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,19]]},"assertion":[{"value":"19 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was reviewed, and ethical approval was granted by the Ghana Health Service Ethics Review Committee (GHS-ERC) with approval number GHS-ERC-011\/03\/20 and the Ethics Committee for Basic and Applied Sciences (ECBAS), University of Ghana, with approval number (ECBA 016\/22\u201323). Written informed consent was obtained for all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"247"}}