{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:13:45Z","timestamp":1760058825693,"version":"build-2065373602"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Children living with perinatally-acquired HIV-1 (CPHIV) face significant health challenges despite advancements in antiretroviral therapy (ART). This study aimed to determine the association between unsuppressed HIV RNA viral load (VL), proinflammatory markers, sociodemographic, and clinical factors among CPHIV attending routine ART clinic at Arthur Davison Children\u2019s Hospital (ADH), Ndola, Zambia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional study on 135 CPHIV, aged 2\u221218 years, who had been on ART for over 12 months. Sociodemographic, clinical, and laboratory data were collected using a standardized questionnaire and a data collection form. The primary outcome was unsuppressed HIV RNA VL defined as a viral load greater than 1000 copies\/mL of HIV-1 RNA after at least 6 months of ART treatment. Bivariate and multivariate logistic analyses were conducted to assess associations with unsuppressed HIV viral load.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Overall median (Q1 - Q3) age was 15 years (12\u201317) and 59.3% were male. The proportion of CPHIV with unsuppressed HIV VL was 15.6% (n\u2009=\u200921, 95% confidence interval (CI): 9.9\u201322.8%). Factors associated with unsuppressed VL in multivariate logistic regression were poor adherence to ART (missing two or more doses in 2 weeks) (adjusted OR (AOR) = 14.96; 95% CI: 2.39\u201393.49, p\u2009=\u20090.004) and lower CD4 count (AOR; 0.99, 0.99\u20131.00, p\u2009=\u20090.026). Proinflammatory markers tumor necrosis factor-alpha (TNF-\u03b1) (p\u2009=\u20090.196) and D-dimer (p\u2009=\u20090.709) did not differ between the suppressed and unsuppressed CPHIV.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>One in six children with perinatally acquired HIV in Ndola, Zambia, had unsuppressed viral load, which was associated with poor ART adherence and lower CD4 counts. Proinflammatory markers, TNF-\u03b1 and D-dimer, showed no significant differences between suppressed and unsuppressed groups, suggesting they may not be reliable indicators of viral control. Enhanced adherence support and further research on immune dysregulation are needed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0334109","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:25:13Z","timestamp":1760030713000},"page":"e0334109","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pro-inflammation and clinical correlates of unsuppressed HIV-viral load in children living with perinatally-acquired HIV 1 in Zambia"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9687-2113","authenticated-orcid":true,"given":"John","family":"Nzobokela","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lweendo","family":"Muchaili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kingsley","family":"Kamvuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bislom C.","family":"Mweene","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Situmbeko","family":"Liweleya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney","family":"Mulamfu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benson M.","family":"Hamooya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4376-5831","authenticated-orcid":true,"given":"Sepiso K.","family":"Masenga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"issue":"9","key":"pone.0334109.ref001","first-page":"961","article-title":"Human immunodeficiency virus infection in children","volume":"52","author":"EH Hoernle","year":"1995","journal-title":"AJHP"},{"issue":"4","key":"pone.0334109.ref002","doi-asserted-by":"crossref","first-page":"723","DOI":"10.4236\/ojped.2021.114067","article-title":"Factors associated with the unsuppressed viral load of children on antiretroviral therapy followed up in the Gb\u00eak\u00ea region (C\u00f4te d\u2019Ivoire)","volume":"11","author":"TAA H\u00e9l\u00e8ne","year":"2021","journal-title":"Open J Pediatr"},{"key":"pone.0334109.ref003","first-page":"513","article-title":"Unsuppressed viral load level in public health facilities: nonvirological predictors among adult antiretroviral therapy users in southwestern Ethiopia","volume":"13","author":"B Waju","year":"2021","journal-title":"HIVAIDS Auckl NZ"},{"key":"pone.0334109.ref004","article-title":"Biological aging and immune senescence in children with perinatally acquired HIV","author":"A Dalzini","year":"2020","journal-title":"J Immunol Res"},{"key":"pone.0334109.ref005","doi-asserted-by":"crossref","first-page":"1165964","DOI":"10.3389\/fimmu.2023.1165964","article-title":"Persistent immune activation and altered gut integrity over time in a longitudinal study of Ugandan youth with perinatally acquired HIV","volume":"14","author":"S Dirajlal-Fargo","year":"2023","journal-title":"Front Immunol"},{"issue":"15","key":"pone.0334109.ref006","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.1097\/QAD.0000000000003384","article-title":"Subclinical cardiac disease in children with perinatally acquired HIV is associated with inflammation","volume":"36","author":"SK Masenga","year":"2022","journal-title":"AIDS"},{"key":"pone.0334109.ref007","unstructured":"UNIAIDS [Internet]. 2023 [cited 2024 Sep 22]. 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