{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T05:19:18Z","timestamp":1764652758953,"version":"3.46.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"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. Immunol."],"abstract":"\n Objective<\/jats:title>\n \n This systematic review and meta-analysis aims to characterize the distribution of HIV-1 viral tropism at diagnosis among people living with HIV (PLWH) and examine its association with baseline CD4\n +<\/jats:sup>\n T lymphocyte counts, thereby providing an evidence base for optimizing clinical interventions.\n <\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n \n Observational studies reporting viral tropism prevalence and\/or baseline CD4\n +<\/jats:sup>\n T cell counts stratified by tropism were retrieved from PubMed, Web of Science, Embase, and Cochrane Library. A random-effects model was employed for pooled prevalence estimation and mean difference calculation. Heterogeneity was quantified using I\u00b2 statistics, with subgroup analyses and sensitivity tests to identify heterogeneity sources.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 27 articles (N\u00a0=\u00a09372) were included in this study to analyze the distribution of viral tropism, and the prevalence of Non-R5 tropism was 15.68%. Subgroup analysis showed that the prevalence of Non-R5 IDU (27.86%) was significantly higher than that of sexual transmission (15.29%) and other routes (4.62%). The prevalence of Non-R5 tropism in the CRF01_AE subtype group (30.02%) was significantly higher than that of the B subtype (15.33%) and other subtypes (3.44%) (\n P<\/jats:italic>\n \u2264 0.05). A comparison of CD4\n +<\/jats:sup>\n T cell counts (17 articles) showed a difference of \u221297.77 cells\/\u03bcL for the Non-R5 tropic group relative to the R5 group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our study find that PLWH with Non-R5 virus had more severe immune damage at diagnosis compared to PLWH with R5 virus. This can update the baseline status of patients in clinical practice. since this is a cross-sectional study, future cohort studies should be conducted to verify the relationship between tropism and changes in immunological indicators.<\/jats:p>\n <\/jats:sec>\n \n Systematic Review Registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n , identifier CRD420251088996.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1701028","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T05:14:17Z","timestamp":1764652457000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["High prevalence of baseline Non-R5 viral tropism in PLWH is associated with immune damage: a systematic review and 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