Determinants of CD4 count recovery among severely immunosuppressed HIV patients initiated on antiretroviral therapy: a prospective cohort study in KwaZulu-Natal, South Africa

Delayed CD4 recovery among males, urban residents, TB-coinfected participants, and those with unsuppressed viral load (>400 copies/mL) underscores the need for targeted, differentiated HIV care strategies to accelerate immunological recovery and reduce HIV-related morbidity. Policymakers should prioritise male-focused interventions, strengthened TB-HIV integrated services, intensified adherence and viral load monitoring, and context-specific interventions in urban settings to accelerate immunological recovery and reduce HIV-related morbidity.