Author:
Said Mirvat,W. Bartlett Adam
Abstract
Human immunodeficiency virus (HIV) infection results in progressive decline in immune function ultimately leading to acquired immunodeficiency syndrome (AIDS) characterised by increased susceptibility to opportunistic infections and malignancies. In addition, it causes immune dysfunction, which manifests as a persistent inflammatory state due to dysregulation of cytokine production. Antiretroviral therapy (ART) not only improves immune function but also mitigates systemic immune activation associated with disease progression. Early initiation of ART in children living with HIV has led to a growing cohort surviving into adolescence and beyond. As such, they will experience lifelong exposure to an array of physiologic processes associated with systemic infection, immune dysfunction and antiretroviral medications. This leaves them not only susceptible to a range of morbidities associated with chronic inflammation, immune dysregulation, and drug toxicity but also vulnerable to treatment fatigue leading to issues with treatment adherence and engagement in care. Children experience additional barriers to maintaining suppressive ART due to limited paediatric-friendly formulations that are palatable and contribute to regimen complexity. Tolerability and durability of long-term ART are integral in optimising outcomes for children and adolescents living with HIV and maximising viability of future ART regimens throughout adulthood.
Reference50 articles.
1. United Nations International Children’s Emergency Fund. HIV and AIDS. 2019. Available from: https://www.unicef.org/hiv
2. United Nations International Children’s Emergency Plan. Adolescent HIV prevention. 2019. Available from: https://data.unicef.org/topic/hivaids/adolescents-young-people/
3. Initiative CHA. HiV market report - the state of HiV treatment, testing, and prevention in low-and middle-income countries; 2019
4. Akase IE, Musa BOP, Obiako RO, Ahmad Elfulatiy A, Mohammed AA. Immune dysfunction in HIV: A possible role for pro- and anti-inflammatory cytokines in HIV staging. Journal of Immunology Research. 2017;2017:4128398
5. Alvarez P, Mwamzuka M, Marshed F, Kravietz A, Ilmet T, Ahmed A, et al. Immune activation despite preserved CD4 T cells in perinatally HIV-infected children and adolescents. PLoS One. 2017;12(12):e0190332
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