{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:50:50Z","timestamp":1792021850888,"version":"4.4.0"},"reference-count":71,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Airlangga University Research Fund","award":["9521\/UN3.FK\/PT.01.03\/2023"],"award-info":[{"award-number":["9521\/UN3.FK\/PT.01.03\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Immunological non-response (INR) to antiretroviral therapy (ART) is a critical concern for PLHIV, characterized by inadequate CD4+ T-cell recovery despite virological suppression. This retrospective study analyzed medical records of virologically suppressed adult PLHIV on ART (2004\u20132024) at two hospitals in Surabaya, Indonesia, using four operational categories to identify clinical and demographic determinants of INR. Patients were classified as immunological responders (IRs) or non-responders (INRs) based on four definitions: INR1 (CD4+ gain &lt; 100 cells\/mm3), INR2 (CD4+ &lt; 350 cells\/mm3), INR3 (meeting of either criterion), and INR4 (meeting of both criteria). Of 464 patients, 382 were analyzed. Baseline CD4+ &lt; 200 cells\/mm3 strongly predicted INR2 (aOR = 5.60, 95% CI: 2.95\u201310.62) and INR3 (aOR = 4.46, 95% CI: 2.39\u20138.29), while anal sexual transmission was protective against INR2 (aOR = 0.42, 95% CI: 0.19\u20130.92) and INR3 (aOR = 0.41, 95% CI: 0.19\u20130.89). By month 12, IR groups had over 350 CD4+ cells\/mm3, with faster recovery slopes in months 0\u20136 (IR: &gt;20 vs. INR: &lt;10 cells\/mm3\/month). INR1 and INR4 had flat or negative slopes at 12\u201324 months, while IR groups had positive slopes. Baseline CD4+ was the strongest INR predictor, suggesting the value of early ART and individualized care for Indonesian PLHIV.<\/jats:p>","DOI":"10.3390\/v17121581","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T15:14:06Z","timestamp":1764861246000},"page":"1581","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Defining and Predicting HIV Immunological Non-Response: A Multi-Definition Analysis from an Indonesian Cohort"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9113-1297","authenticated-orcid":false,"given":"Brian Eka","family":"Rachman","sequence":"first","affiliation":[{"name":"Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"},{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"},{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0492-2398","authenticated-orcid":false,"given":"Yehuda Tri Nugroho","family":"Supranoto","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya Isfandiary","family":"Iskandar","sequence":"additional","affiliation":[{"name":"Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9869-5098","authenticated-orcid":false,"given":"Tri Pudy","family":"Asmarawati","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"},{"name":"Universitas Airlangga Hospital, Surabaya 60116, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Qamariyah","family":"Khairunisa","sequence":"additional","affiliation":[{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Vitanata","family":"Arfijanto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Hadi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-6033","authenticated-orcid":false,"given":"Muhammad","family":"Miftahussurur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"},{"name":"Helicobacter pylori and Microbiota Study Group, Institute of Tropical Medicine, Universitas Airlangga, Surabaya 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasronudin","family":"Nasronudin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"},{"name":"Universitas Airlangga Hospital, Surabaya 60116, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5525-9915","authenticated-orcid":false,"given":"Masanori","family":"Kameoka","sequence":"additional","affiliation":[{"name":"Center for Infectious Diseases, Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan"},{"name":"Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe 654-0142, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Retno Pudji","family":"Rahayu","sequence":"additional","affiliation":[{"name":"Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia"},{"name":"Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Universitas Airlangga, Surabaya 60132, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2558-2046","authenticated-orcid":false,"given":"Afif Nurul","family":"Hidayati","sequence":"additional","affiliation":[{"name":"Universitas Airlangga Hospital, Surabaya 60116, Indonesia"},{"name":"Department of Dermatology Venereology and Aesthetics, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Noiman, A., Esber, A., Wang, 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