{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:55Z","timestamp":1789448575365,"version":"build-2803163510"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Background<\/jats:title>\n Persistent systemic inflammation remains a hallmark of treated HIV infection and is not reliably resolved by virological suppression alone. The Systemic Immune-Inflammation Index (SII), a composite hematologic index [(neutrophil \u00d7 platelet)\/lymphocyte count], has emerged as a candidate inflammatory biomarker. Longitudinal SII data following antiretroviral therapy (ART) initiation in pediatric HIV are lacking.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single-center retrospective paired longitudinal study included 30 pediatric patients with HIV with laboratory data at baseline and 12 months post-ART. The primary outcome was change in SII; secondary outcomes included CD4%, HIV RNA, and double-negative T-cell percentage (DNT%). Non-improvers were characterized by age, sex, ART regimen, nutritional status, and co-infection status. Paired comparisons used the Wilcoxon signed-rank test; Spearman correlation was the primary inferential method, with Pearson as a sensitivity analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Median SII declined numerically (342,637 to 250,527) but did not reach significance (\n p<\/jats:italic>\n =\u00a00.428), despite significant improvement in CD4% (\n p<\/jats:italic>\n \u00a0&lt;\u00a00.001) and HIV RNA (\n p<\/jats:italic>\n &lt;\u00a00.001). SII failed to improve in 13\/30 patients (43.3%). The baseline inverse correlation between SII and CD4% (\n r<\/jats:italic>\n = \u22120.450,\n p<\/jats:italic>\n \u00a0=\u00a00.013) was substantially attenuated at month 12 (\n r<\/jats:italic>\n = \u22120.004,\n p<\/jats:italic>\n \u00a0=\u00a00.985). A parametric correlation between \u0394SII and \u0394HIV RNA (\n r<\/jats:italic>\n = +0.534,\n p<\/jats:italic>\n \u00a0=\u00a00.002) was not confirmed on rank-based testing (\u03c1 = +0.004), reflecting leverage from two extreme-viremia patients. The 1\u20132-year age group had the highest rate of SII non-improvement (75.0%); an unadjusted\n post-hoc<\/jats:italic>\n comparison with the 6\u201311-year group yielded a nominal\n p<\/jats:italic>\n value of 0.038. Female sex was more frequent among non-improvers (53.8% vs. 17.6%;\n p<\/jats:italic>\n \u00a0=\u00a00.056), although the difference was not statistically significant. Genvoya\n \u00ae<\/jats:sup>\n use showed a similar non-significant trend (\n p<\/jats:italic>\n \u00a0=\u00a00.132). Nutritional status, herpesvirus co-infection, and virological suppression at month 12 were not significantly associated with SII trajectory.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In this pediatric HIV cohort, SII failed to improve in nearly half of patients despite successful ART, dissociating from both CD4 reconstitution and HIV RNA suppression. These findings suggest SII reflects a residual inflammatory state driven by mechanisms beyond viral replication, including ART class-specific, sex-related, and developmental factors. Routine SII monitoring may identify patients at ongoing inflammatory risk despite virological success; larger prospective studies are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1918829","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:55Z","timestamp":1789446415000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamics of virological suppression and systemic immune-inflammatory response following antiretroviral therapy in pediatric HIV infection"],"prefix":"10.3389","volume":"16","author":[{"given":"Mavera","family":"U\u015fakl\u0131o\u011flu Erol","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Infectious Diseases, Istanbul University, Istanbul Faculty of Medicine","place":["Istanbul, T\u00fcrkiye"]},{"name":"Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Health Sciences T\u00fcrkiye, Istanbul Training and Research Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behiye Benayg\u00fcl","family":"Ka\u00e7maz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Infectious Diseases, Istanbul University, Istanbul Faculty of Medicine","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayper","family":"Somer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Infectious Diseases, Istanbul University, Istanbul Faculty of Medicine","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selda","family":"Han\u00e7erli T\u00f6r\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Infectious Diseases, Istanbul University, Istanbul Faculty of Medicine","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1186\/1742-4690-3-s1-s98","article-title":"Microbial translocation is a cause of systemic immune activation in chronic HIV infection","volume":"12","author":"Brenchley","year":"2006","journal-title":"Nat. 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