{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:24:19Z","timestamp":1785435859547,"version":"3.56.0"},"reference-count":60,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u2018Victor Babe\u0219\u2019 University of Medicine and Pharmacy"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Residual inflammation remains a hallmark of treated HIV infection despite durable viral suppression. Whether previous SARS-CoV-2 infection is associated with residual inflammation in people living with HIV (PLWH) remains incompletely understood. This study evaluated the association between previous COVID-19 and persistent inflammation in virally suppressed PLWH. In this retrospective observational single-center study, 286 adults receiving antiretroviral therapy between January 2023 and December 2025 were included. Patients were stratified according to documented SARS-CoV-2 infection history. A secondary analysis included 231 individuals with sustained viral suppression (HIV-RNA &lt; 50 copies\/mL). Inflammatory biomarkers, immune recovery parameters, metabolic characteristics, and independent predictors of elevated inflammatory biomarker levels were evaluated. Previous SARS-CoV-2 infection was associated with significantly higher concentrations of C-reactive protein, interleukin-6, tumor necrosis factor-\u03b1, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (all p &lt; 0.01). Among virally suppressed patients, elevated inflammatory biomarker levels were associated with lower CD4+ T-cell counts, lower CD4\/CD8 ratios, obesity, metabolic syndrome, dyslipidemia, and hepatic steatosis. Previous SARS-CoV-2 infection, obesity, metabolic syndrome, and CD4+ T-cell counts &lt; 500 cells\/mm3 were independently associated with elevated inflammatory biomarker levels. Previous SARS-CoV-2 infection was independently associated with an unfavorable inflammatory profile in virally suppressed people living with HIV. Given the retrospective observational design, these findings should be interpreted as associations rather than evidence of causality. These findings suggest that long-term host-related and metabolic factors may contribute to residual inflammation beyond viral control and highlight the need for prospective studies investigating strategies to reduce residual immune activation in treated HIV infection.<\/jats:p>","DOI":"10.3390\/microorganisms14081624","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:26:23Z","timestamp":1785115583000},"page":"1624","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Prior SARS-CoV-2 Infection with Immune Activation in Virally Suppressed People Living with HIV"],"prefix":"10.3390","volume":"14","author":[{"given":"Madalina-Ianca","family":"Suba","sequence":"first","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinical Hospital of Infectious Diseases and Pulmonology \u201cVictor Babes\u201d, Gheorghe Adam Street 13, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8236-2205","authenticated-orcid":false,"given":"Ovidiu","family":"Rosca","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinical Hospital of Infectious Diseases and Pulmonology \u201cVictor Babes\u201d, Gheorghe Adam Street 13, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4924-7832","authenticated-orcid":false,"given":"Bogdan","family":"Hogea","sequence":"additional","affiliation":[{"name":"\u201cPius Brinzeu\u201d Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania"},{"name":"Department XV, Discipline of Orthopedics-Traumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Profesor Universitar Doctor Teodor \u0218ora Research Centre, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-3714","authenticated-orcid":false,"given":"Camelia Corina","family":"Pescaru","sequence":"additional","affiliation":[{"name":"Center for Research and Innovation in Personalized Medicine of Respiratory Diseases (CRIPMRD), \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7865-9915","authenticated-orcid":false,"given":"Florina Cristiana","family":"Lucaciu","sequence":"additional","affiliation":[{"name":"Clinical Hospital of Infectious Diseases and Pulmonology \u201cVictor Babes\u201d, Gheorghe Adam Street 13, 300310 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6185-0960","authenticated-orcid":false,"given":"Ahmed","family":"Abu-Awwad","sequence":"additional","affiliation":[{"name":"\u201cPius Brinzeu\u201d Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania"},{"name":"Department XV, Discipline of Orthopedics-Traumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"},{"name":"Profesor Universitar Doctor Teodor \u0218ora Research Centre, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian-Cosmin","family":"Ilie","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sanitary Management, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Centre for Translational Research and Systems Medicine, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pop","sequence":"additional","affiliation":[{"name":"Department XV, Discipline of Orthopedics-Traumatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6793-5361","authenticated-orcid":false,"given":"Simona-Alina","family":"Abu-Awwad","sequence":"additional","affiliation":[{"name":"\u201cPius Brinzeu\u201d Emergency Clinical County Hospital, Bld Liviu Rebreanu, No. 156, 300723 Timisoara, Romania"},{"name":"Department of Obstetrics and Gynecology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","unstructured":"Kemnic, T.R., Patel, P., and Gulick, P.G. 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