Immunological Parameters Associated With AIDS-Definingand Non-AIDS-Defining Conditions in People Living withHIV on Antiretroviral Therapy: A Scoping Review Protocol

Abstract

Despite the effectiveness of antiretroviral therapy (ART), people living with HIV (PLWH) remain susceptible to a wide range of clinical complications, including AIDS-defining illnesses (ADIs) and non-AIDS-defining conditions (NADCs). While CD4+ T cell count is the most widely used immunological marker in clinical settings, additional parameters such as CD8+ T cell subsets, the CD4/CD8 ratio, markers of immune activation, and inflammatory cytokines have also been associated with disease outcomes in this population. However, evidence regarding these associations remains fragmented across different studies, populations, and methodologies. This scoping review aims to systematically map the immunological parameters that have been reported in relation to ADIs and NADCs in PLWH receiving ART. The review follows the Joanna Briggs Institute (JBI) methodological guidance and the PRISMA-ScR reporting framework. Searches will be conducted in Ovid MEDLINE, Embase, Cochrane CENTRAL, Web of Science, and LILACS, with supplementary searches in Google Scholar and institutional repositories. Eligible studies will include original research involving adults living with HIV on ART reporting associations between immunological parameters and clinical outcomes. Two independent reviewers will conduct screening and data extraction using Rayyan, with blinded bibliographic fields during title and abstract screening. Discrepancies will be resolved by a third reviewer. Descriptive synthesis will be used to summarize findings; no critical appraisal or meta-analysis is planned. This protocol was registered on the Open Science Framework (OSF) on July 26, 2025 (DOI: https://doi.org/10.17605/OSF.IO/XJ4ZT). The results of this review are expected to inform future research and support the development of immunological monitoring strategies for ART-treated PLWH by identifying studied biomarkers, methodological trends, and knowledge gaps.