Immunological effectiveness of antiretroviral therapy in key groups of men

Abstract

As of 3 September 2025, there were 15,095 people living with human immunodeficiency virus (HIV) registered in the Kyrgyz Republic. Antiretroviral therapy is received by 6,393 people living with HIV, of whom 5,374 (84.06%) have achieved a viral load of <50 copies/ml. The modern treatment regimen of two nucleoside reverse transcriptase inhibitors + dolutegravir is taken by 5,100 (79.77%) patients. Among people who inject drugs, in 2025, compared to 2018, there was a 14.09% decrease in the proportion of men with a CD4 count <200 cells/μl who were in the first clinical stage of HIV infection. In the group of men with probable heterosexual transmission, the proportion of patients with low immune status at the first clinical stage decreased by 5.69% over the same period. The most pronounced decrease in this indicator was recorded among men with homosexual transmission – by 24.96% compared to 2018. The aim of the study was to evaluate the immunological effectiveness of antiretroviral therapy among key groups of men. Data from 15,095 registered HIV cases and 9,006 men ≥18 years of age were analysed. Changes in CD4+ T-cell levels were studied over time: before the start of antiretroviral therapy and on 3 September 2025, with comparison to 2018 data. Among men who have sex with men, the proportion of patients with CD4 levels > 500 cells/μl increased from 23.25% (2018) to 62.28% (2025), reflecting a 33.4% increase in immunological effectiveness. Among people who inject drugs, the increase was 34.5%, and among men infected through heterosexual contact, it was 30.5%. Early initiation of antiretroviral therapy demonstrates advantages: better immune recovery dynamics, reduced risk of AIDS and associated pathologies, and reduced mortality compared to late initiation of treatment