{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:07:57Z","timestamp":1788862077987,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Prevention and Control of Emerging and Major Infectious Diseases\u2014National Science and Technology Major Project","award":["2025ZD01904904"],"award-info":[{"award-number":["2025ZD01904904"]}]},{"name":"Chongqing Medical Scientific Research Project","award":["2026DBXM001"],"award-info":[{"award-number":["2026DBXM001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Late presentation and poor immunovirological outcomes persist among people living with HIV (PLWH). The differential impact of HIV-1 subtypes on baseline disease presentation in antiretroviral therapy (ART)-na\u00efve individuals remains incompletely characterized, particularly in regions dominated by unique recombinant forms. Methods: We conducted a retrospective cross-sectional study involving ART-na\u00efve newly diagnosed PLWH at our hospital from January 2020 to October 2025. Immunological (CD4+, CD8+ T-cell counts, and CD4+\/CD8+ ratios), biochemical [albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], virological (HIV-1 subtype, genotypic drug resistance), and clinical (admission type, age) parameters were analyzed. Multivariate linear regression identified factors independently associated with CD4+ T-cell count, CD4+\/CD8+ ratio, and ALB level. Results: The study population comprised 762 ART-na\u00efve newly diagnosed PLWH who were predominantly male (87.5%), older (median age 59), and presented with advanced immunosuppression (median CD4+ count 100 cells\/\u00b5L). CRF07_BC was the dominant subtype (57.4%). Significant subtype-specific differences were observed: CRF01_AE infection was associated with the lowest CD4+ counts (median 54 cells\/\u00b5L, p = 0.0004) and CD4+\/CD8+ ratios (p = 0.0005). Inpatient status, indicating more severe presentation, was independently associated with significantly lower CD4+ counts (\u03b2 = \u221236.91, p &lt; 0.0001) and ALB levels (\u03b2 = \u22127.358, p &lt; 0.0001). Contrary to typical immune aging, patients aged \u226550 years had higher CD4+ counts at diagnosis (105.5 vs. 74 cells\/\u00b5L, p = 0.0039). Genotypic drug resistance (22.2% prevalence) showed no independent association with baseline immunological status. Conclusions: Our findings reveal a distinct profile of late HIV presentation in a contemporary Chinese cohort, characterized by advanced age and the predominance of CRF07_BC. The independent association of inpatient status, rather than HIV-1 subtype or drug resistance, with severe immunosuppression and hypoalbuminemia highlights clinical presentation as the paramount indicator of baseline disease severity. The unexpected immunological advantage in older adults warrants further investigation.<\/jats:p>","DOI":"10.3390\/v18090986","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:02:24Z","timestamp":1788858144000},"page":"986","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Late Clinical Presentation Outweighs Viral Characteristics in Determining Immune Depletion at HIV Diagnosis: A Five-Year Retrospective Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6784-4986","authenticated-orcid":false,"given":"Silvere D.","family":"Zaongo","sequence":"first","affiliation":[{"name":"Clinical Research Center, Chongqing Public Health Medical Center, 109 Baoyu Road, Geleshan Town, Shapingba District, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Han","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Chongqing Public Health Medical Center, 109 Baoyu Road, Geleshan Town, Shapingba District, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3229-0108","authenticated-orcid":false,"given":"Yaokai","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Chongqing Public Health Medical Center, 109 Baoyu Road, Geleshan Town, Shapingba District, Chongqing 400036, China"},{"name":"Department of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Geleshan Town, Shapingba District, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1468-1293.2010.00857.x","article-title":"Late presentation of HIV infection: A consensus definition","volume":"12","author":"Antinori","year":"2011","journal-title":"HIV Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mocroft, A., Lundgren, J.D., Sabin, M.L., Monforte, A., Brockmeyer, N., Casabona, J., Castagna, A., Costagliola, D., Dabis, F., and De Wit, S. 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