{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:53:50Z","timestamp":1791827630091,"version":"4.3.4"},"reference-count":164,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"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:p>\n                    Immunological Nonresponse (INR) in people living with HIV (PLWH) is characterized by inadequate CD4\n                    <jats:sup>+<\/jats:sup>\n                    T-cell recovery despite effective viral suppression through antiretroviral therapy (ART). This systematic review and meta-analysis identify key clinical, demographic, and molecular predictors of INR to optimize immune recovery strategies. A comprehensive literature search was conducted in accordance with PRISMA 2020 guidelines, yielding 59 eligible studies, with a total of 19,511 individuals with INR. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and pooled effect estimates were calculated as odds ratio (OR), mean difference (MD), or standardized mean difference (SMD). Significant predictors of INR included male sex [OR 1.33 (1.12\u20131.58)], older age [MD 2.61 (1.42\u20133.81)], intravenous drug use [OR 1.67 (1.15\u20132.42)], hepatitis B coinfection [OR 1.30 (1.08\u20131.57)], hepatitis C coinfection [OR 1.85 (1.50\u20132.28)], tuberculosis [OR 1.77 (1.41\u20132.21)], advanced HIV stage [OR 2.66 (2.34\u20133.02)], and lower baseline and nadir CD4\n                    <jats:sup>+<\/jats:sup>\n                    counts [SMD \u22123.82 (\u22124.94-(\u22122.70)), SMD \u22121.69 (\u22122.69-(\u22120.68))], respectively. Additionally, 57 biomarkers were identified as potential predictors of INR, implicating several immunological pathways. These findings underscore the multifactorial nature of INR and the need for personalized approaches among ART-treated individuals.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0358793","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:42:45Z","timestamp":1791826965000},"page":"e0358793","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of immunological non-response despite virological suppression in people living with HIV on antiretroviral therapy: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9113-1297","authenticated-orcid":true,"given":"Brian Eka","family":"Rachman","sequence":"first","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Doctoral Program of Medical Science, Faculty of Medicine"]},{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0492-2398","authenticated-orcid":true,"given":"Yehuda Tri Nugroho","family":"Supranoto","sequence":"additional","affiliation":[{"name":"Master of Medical Sciences in Clinical Investigation, Harvard Medical School","place":["Boston, Massachusetts, United States of America"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fitri Revita","family":"Nurannisa","sequence":"additional","affiliation":[{"name":"Universitas Gadjah Mada","place":["Yogyakarta, Indonesia"],"department":["Master of Public Health Program, Faculty of Medicine, Public Health, and Nursing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Mei","family":"Saroh","sequence":"additional","affiliation":[{"name":"Universitas Gadjah Mada","place":["Yogyakarta, Indonesia"],"department":["Center for Tropical Medicine, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Qamariyah","family":"Khairunisa","sequence":"additional","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Institute of Tropical Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Citrawati Dyah Kencono","family":"Wungu","sequence":"additional","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Institute of Tropical Disease"]},{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Department of Physiology and Medical Biochemistry, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1971-7816","authenticated-orcid":true,"given":"Dian Paramita","family":"Kartikasari","sequence":"additional","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Department of Cardiology and Vascular Medicine, Faculty of Medicine"]},{"name":"Universitas Airlangga Hospital","place":["Surabaya, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasronudin","family":"Nasronudin","sequence":"additional","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Division of Tropical Medicine and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine"]},{"name":"Universitas Airlangga Hospital","place":["Surabaya, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5525-9915","authenticated-orcid":true,"given":"Masanori","family":"Kameoka","sequence":"additional","affiliation":[{"name":"Kobe University Graduate School of Medicine","place":["Kobe, Japan"],"department":["Division of Global and Environmental Health Sciences, Department of Future Social Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Miftahussurur","sequence":"additional","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo Teaching Hospital"]},{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Helicobacter pylori and Microbiota Study Group, Institute Tropical Disease"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Retno Pudji","family":"Rahayu","sequence":"additional","affiliation":[{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Institute of Tropical Disease"]},{"name":"Universitas Airlangga","place":["Surabaya, Indonesia"],"department":["Department of Oral and Maxillofacial Pathology, Faculty of 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