{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:28:51Z","timestamp":1785414531394,"version":"3.56.0"},"reference-count":25,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0HIV is associated with chronic inflammation and immune activation, which can persist even in individuals on antiretroviral therapy (ART), increasing the risk of cardiovascular disease, neurocognitive disorders, and other inflammatory conditions.\nObjective:\u00a0This study comparatively investigates inflammatory markers among HIV-positive individuals receiving ART with those in HIV-negative individuals.\nMethods:\u00a0We analysed retrospective laboratory results, including viral load, C-reactive protein (CRP), and D-dimer, from 275 individuals (aged 0\u201339 years) treated at a tertiary hospital in South Africa. The study period commenced on 02 December 2023 and ended on 28 October 2024. Spearman\u2019s rank correlation was used to evaluate relationships among demographic factors, viral load, and inflammatory markers.\nResults:\u00a0Findings revealed that HIV-positive individuals had significantly higher CRP levels (r\u00a0= 0.140,\u00a0p\u00a0= 0.010), indicating persistent inflammation despite ART. D-dimer levels remained high within normal ranges across the sample, suggesting a generally low thrombotic risk, though elevated in a small subset of HIV-positive individuals. It also revealed that CRP levels were notably higher among male patients (r\u00a0= 0.133,\u00a0p\u00a0= 0.014) compared to female patients. The age group with the highest inflammatory markers, such as CRP, were young adults (18\u201339 years old). Distribution results show the predominant gender being female (n\u00a0= 211; 76.7%) versus male (n\u00a0= 64; 23.3%).\nConclusion:\u00a0This study highlights the need for tailored strategies to manage inflammation and reduce cardiovascular risks in HIV-positive individuals, especially young adults and male patients.\nWhat this study adds:\u00a0This study provides insight into specific inflammatory markers that are reduced or elevated in people living with HIV. It also assessed how ART influences the immune response in HIV-positive individuals, particularly in terms of inflammation. This can help in developing targeted therapies and monitoring disease progression.<\/jats:p>","DOI":"10.4102\/ajlm.v14i1.2756","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T07:55:51Z","timestamp":1758786951000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative analysis of inflammatory markers in HIV-positive individuals on antiretroviral therapy versus HIV-negative individuals in South Africa"],"prefix":"10.4102","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8321-6993","authenticated-orcid":false,"given":"Lungile","family":"Ndlovu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/054r97095","id-type":"ROR","asserted-by":"publisher"}],"name":"Mangosuthu University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9146-3809","authenticated-orcid":false,"given":"Nokukhanya","family":"Thembane","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/054r97095","id-type":"ROR","asserted-by":"publisher"}],"name":"Mangosuthu University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1053-5458","authenticated-orcid":false,"given":"Ziningi N.","family":"Jaya","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/054r97095","id-type":"ROR","asserted-by":"publisher"}],"name":"Mangosuthu University of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Thurlow J, Gow J, George G. HIV\/AIDS, growth and poverty in KwaZulu-Natal and South Africa: An integrated survey, demographic and economy-wide analysis. J Int AIDS Soc. 2009;12:1\u20133. https:\/\/doi.org\/10.1186\/1758-2652-12-18","DOI":"10.1186\/1758-2652-12-18"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Conan N, Simons E, Chihana ML, et al. Increase in HIV viral suppression in KwaZulu-Natal, South Africa: Community-based cross sectional surveys 2018 and 2013. What remains to be done? PLoS One. 2022;17(3):e0265488. https:\/\/doi.org\/10.1371\/journal.pone.0265488","DOI":"10.1371\/journal.pone.0265488"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Ntombela NP, Kharsany AB, Soogun A, et al. Viral suppression among pregnant adolescents and women living with HIV in rural KwaZulu-Natal, South Africa: A cross sectional study to assess progress towards UNAIDS indicators and Implications for HIV Epidemic Control. Reprod Health. 2022;19(1):116. https:\/\/doi.org\/10.1186\/s12978-022-01419-5","DOI":"10.1186\/s12978-022-01419-5"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Lv T, Cao W, Li T. HIV-related immune activation and inflammation: Current understanding and strategies. J Immunol Res. 2021;2021(1):7316456. https:\/\/doi.org\/10.1155\/2021\/7316456","DOI":"10.1155\/2021\/7316456"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Guerville F, Vialemaringe M, Cognet C, et al. Mechanisms of systemic low-grade inflammation in HIV patients on long-term suppressive antiretroviral therapy: The inflammasome hypothesis. AIDS. 2023;37(7):1035\u20131046. https:\/\/doi.org\/10.1097\/QAD.0000000000003546","DOI":"10.1097\/QAD.0000000000003546"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Ashuro AA, Fan YG, Fu YS, et al. The effect of rosuvastatin on plasma\/serum levels of high-sensitivity C-reactive protein, interleukin-6, and D-dimer in people living with human immunodeficiency virus: A systematic review and meta-analysis. AIDS Res Hum Retroviruses. 2021;37(11):821\u2013833. https:\/\/doi.org\/10.1089\/aid.2020.0273","DOI":"10.1089\/aid.2020.0273"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Ou-Yang H, Fu HY, Luo Y, et al. Inflammation markers and the risk of hypertension in people living with HIV. Front Immunol. 2023;14:1133640. https:\/\/doi.org\/10.3389\/fimmu.2023.1133640","DOI":"10.3389\/fimmu.2023.1133640"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Stewart SL, Savenkov O, Hurd MA, et al. Genetic and metabolic determinants of lipoprotein (a). J Clin Lipidol. 2023;17(4):e5\u2013e6. https:\/\/doi.org\/10.1016\/j.jacl.2023.05.009","DOI":"10.1016\/j.jacl.2023.05.009"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Zhang P, Wang C, Wu J, Zhang S. A systematic review of the predictive value of plasma D-dimer levels for predicting stroke outcome. Front Neurol. 2021;12:693524. https:\/\/doi.org\/10.3389\/fneur.2021.693524","DOI":"10.3389\/fneur.2021.693524"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bourgeois C, Gorwood J, Olivo A, et al. Contribution of adipose tissue to the chronic immune activation and inflammation associated with HIV infection and its treatment. Front Immunol. 2021;12:670566. https:\/\/doi.org\/10.3389\/fimmu.2021.670566","DOI":"10.3389\/fimmu.2021.670566"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Punyawudho B, Singkham N, Thammajaruk N, et al. Therapeutic drug monitoring of antiretroviral drugs in HIV-infected patients. Expert Rev Clin Pharmacol. 2016;9(12):1583\u20131595. https:\/\/doi.org\/10.1080\/17512433.2016.1235972","DOI":"10.1080\/17512433.2016.1235972"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Temu TM, Zifodya JS, Polyak SJ, et al. Antiretroviral therapy reduces but does not normalize immune and vascular inflammatory markers in adults with chronic HIV infection in Kenya. AIDS. 2021;35(1):45\u201351. https:\/\/doi.org\/10.1097\/QAD.0000000000002729","DOI":"10.1097\/QAD.0000000000002729"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Masyuko SJ, Page ST, Polyak SJ, et al. Human immunodeficiency virus is associated with higher levels of systemic inflammation among Kenyan adults despite viral suppression. Clin Infect Dis. 2021;73(7):e2034\u2013e2042. https:\/\/doi.org\/10.1093\/cid\/ciaa1650","DOI":"10.1093\/cid\/ciaa1650"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Castillo-Mancilla JR, Brown TT, Erlandson KM, et al. Suboptimal adherence to combination antiretroviral therapy is associated with higher levels of inflammation despite HIV suppression. Clin Infect Dis. 2016;63(12):1661\u20131667. https:\/\/doi.org\/10.1093\/cid\/ciw650","DOI":"10.1093\/cid\/ciw650"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Mabhida SE, Mchiza ZJ, Mokgalaboni K, Hanser S, Choshi J, Mokoena H. High-sensitivity C-reactive protein among people living with HIV on highly active antiretroviral therapy: A systemic review and meta-analysis. BMC Infect Dis. 2024;24(1):160. https:\/\/doi.org\/10.1186\/s12879-024-09050-4","DOI":"10.1186\/s12879-024-09050-4"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Zhu B, Chen X, Shen W, Ding Y, Lin H, He N. Association between inflammation and coagulation biomarkers and carotid atherosclerosis among treated people with human immunodeficiency virus. Open Forum Infect Dis. 2022;9(7):ofac208. https:\/\/doi.org\/10.1093\/ofid\/ofac208","DOI":"10.1093\/ofid\/ofac208"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"De Armas LR, Pallikkuth S, George V, et al. Re-evaluation of immune activation in the era of cART and an aging HIV-infected population. JCI Insight. 2017;2(20):e95726. https:\/\/doi.org\/10.1172\/jci.insight.95726","DOI":"10.1172\/jci.insight.95726"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Peterson TE, Baker JV. Assessing inflammation and its role in comorbidities among persons living with HIV. Curr Opin Infect Dis. 2019;32(1):8\u201315. https:\/\/doi.org\/10.1097\/QCO.0000000000000510","DOI":"10.1097\/QCO.0000000000000510"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Baker J, Ayenew W, Quick H, et al. High-density lipoprotein particles and markers of inflammation and thrombotic activity in patients with untreated HIV infection. J Infect Dis. 2010;201(2):285\u2013292. https:\/\/doi.org\/10.1086\/649560","DOI":"10.1086\/649560"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Nixon DE, Landay AL. Biomarkers of immune dysfunction in HIV. Curr Opin HIV AIDS. 2010;5(6):498\u2013503. https:\/\/doi.org\/10.1097\/COH.0b013e32833ed6f4","DOI":"10.1097\/COH.0b013e32833ed6f4"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Borges AH, O\u2019Connor JL, Phillips AN, et al. INSIGHT SMART and ESPRIT Study Groups and the SILCAAT Scientific Committee. Factors associated with D-dimer levels in HIV-infected individuals. PLoS One. 2014;9(3):e90978. https:\/\/doi.org\/10.1371\/journal.pone.0090978","DOI":"10.1371\/journal.pone.0090978"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Santinelli L, Ceccarelli G, Borrazzo C, et al. Sex-related differences in markers of immune activation in virologically suppressed HIV-infected patients. Biol Sex Differ. 2020;11:1\u20131. https:\/\/doi.org\/10.1186\/s13293-020-00302-x","DOI":"10.1186\/s13293-020-00302-x"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Micieli E, Dentali F, Giola M, Grossi P, Venco A, Ageno W. Venous and arterial thrombosis in patients with HIV infection. Blood Coagulat Fibrin. 2007;18(3):259\u2013263. https:\/\/doi.org\/10.1097\/MBC.0b013e32808738a3","DOI":"10.1097\/MBC.0b013e32808738a3"},{"key":"ref23","unstructured":"Deeks SG. Immune dysfunction, inflammation, and accelerated aging in patients on antiretroviral therapy. Top HIV Med. 2009;17(4):118\u2013123."},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Zicari S, Sessa L, Cotugno N, et al. Immune activation, inflammation, and non-AIDS co-morbidities in HIV-infected patients under long-term ART. Viruses. 2019;11(3):200. https:\/\/doi.org\/10.3390\/v11030200","DOI":"10.3390\/v11030200"}],"container-title":["African Journal of Laboratory Medicine"],"original-title":[],"link":[{"URL":"https:\/\/ajlmonline.org\/index.php\/ajlm\/article\/view\/2756\/3261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T07:56:01Z","timestamp":1758786961000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajlmonline.org\/index.php\/ajlm\/article\/view\/2756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/ajlm.v14i1.2756","relation":{},"ISSN":["2225-2002","2225-2010"],"issn-type":[{"value":"2225-2002","type":"print"},{"value":"2225-2010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]},"article-number":"a2756"}}