{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:06:56Z","timestamp":1791875216598,"version":"4.3.4"},"reference-count":67,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006162","name":"FACEPE","doi-asserted-by":"publisher","award":["APQ-0599-2.02\/14"],"award-info":[{"award-number":["APQ-0599-2.02\/14"]}],"id":[{"id":"10.13039\/501100006162","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006162","name":"FACEPE","doi-asserted-by":"publisher","award":["BEX 7715-15-3"],"award-info":[{"award-number":["BEX 7715-15-3"]}],"id":[{"id":"10.13039\/501100006162","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UFPE (PROPG and PROPESQI)","award":["APQ-0599-2.02\/14"],"award-info":[{"award-number":["APQ-0599-2.02\/14"]}]},{"name":"UFPE (PROPG and PROPESQI)","award":["BEX 7715-15-3"],"award-info":[{"award-number":["BEX 7715-15-3"]}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"publisher","award":["APQ-0599-2.02\/14"],"award-info":[{"award-number":["APQ-0599-2.02\/14"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"publisher","award":["BEX 7715-15-3"],"award-info":[{"award-number":["BEX 7715-15-3"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Decades of studies in antiretroviral therapy (ART) have passed, and the mechanisms that determine impaired immunological recovery in HIV-positive patients receiving ART have not been completely elucidated yet. Thus, T-lymphocytes immunophenotyping and cytokines levels were analyzed in 44 ART-treated HIV-positive patients who had a prolonged undetectable plasma viral load. The patients were classified as immunological non-responders (INR = 13) and immunological responders (IR = 31), according to their CD4+ T cell levels. Evaluating pre-CD4+ levels, we observed a statistically significant trend between lower CD4+ T cell levels and INR status (Z = 3.486, p &lt; 0.001), and during 18 months of ART, the CD4+ T cell levels maintained statistical differences between the INR and IR groups (WTS = 37.252, p &lt; 0.001). Furthermore, the INRs were associated with an elevated age at ART start; a lower pre-treatment CD4+ T cell count and a percentage that remained low even after 18 months of ART; lower levels of recent thymic emigrant (RTE) CD4+ T cell (CD45RA + CD31+) and a na\u00efve CD4+ T cell (CD45RA + CD62L+); higher levels of central memory CD4+ T cells (CD45RA-CD62L+); and higher immune activation by CD4+ expressing HLA-DR+ or both (HLA-DR+ and CD38+) when compared with IRs. Our study demonstrates that thymic exhaustion and increased immune activation are two mechanisms substantially implicated in the impaired immune recovery of ART-treated HIV patients.<\/jats:p>","DOI":"10.3390\/v15020440","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T04:08:07Z","timestamp":1675656487000},"page":"440","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Thymic Exhaustion and Increased Immune Activation Are the Main Mechanisms Involved in Impaired Immunological Recovery of HIV-Positive Patients under ART"],"prefix":"10.3390","volume":"15","author":[{"given":"Maria Carolina","family":"Dos Santos Guedes","sequence":"first","affiliation":[{"name":"Keizo Asami Institute (iLIKA), Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"},{"name":"Department of Genetics, Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wlisses Henrique Veloso","family":"Carvalho-Silva","sequence":"additional","affiliation":[{"name":"Keizo Asami Institute (iLIKA), Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"},{"name":"Aggeu Magalh\u00e3es Institute (IAM\/FIOCRUZ), Recife 50740-465, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Leandro","family":"Andrade-Santos","sequence":"additional","affiliation":[{"name":"Keizo Asami Institute (iLIKA), Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"},{"name":"Department of Genetics, Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carolina Accioly","family":"Brelaz-de-Castro","sequence":"additional","affiliation":[{"name":"Aggeu Magalh\u00e3es Institute (IAM\/FIOCRUZ), Recife 50740-465, PE, Brazil"},{"name":"Vit\u00f3ria Academic Center (CAV), Federal University of Pernambuco\u2014UFPE, Recife 55608-680, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabr\u00edcio Oliveira","family":"Souto","sequence":"additional","affiliation":[{"name":"Keizo Asami Institute (iLIKA), Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"},{"name":"Agreste Academic Center (CAA), Federal University of Pernambuco\u2014UFPE, Recife 55014-900, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Lima","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Keizo Asami Institute (iLIKA), Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"},{"name":"Department of Genetics, Federal University of Pernambuco\u2014UFPE, Recife 50670-901, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"ref_1","unstructured":"UNAIDS (2022, November 01). 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