Gut Mucosal Immunity in HIV-Exposed Infants: A Review

Abstract

Gut mucosal immunity in infants exposed to Human Immunodeficiency Virus (HIV) presents a complex interplay of developmental processes, viral dynamics, and therapeutic interventions that significantly impact clinical outcomes. This review synthesizes current knowledge on the mechanisms, clinical implications, and therapeutic strategies concerning gut mucosal immunity in HIV-exposed infants. The gut mucosa serves as a critical site for immune maturation and defense against pathogens, but HIV infection disrupts this delicate balance, leading to compromised immune function and increased susceptibility to infections. Infants born to HIV-positive mothers experience unique challenges in gut mucosal immunity due to vertical transmission of the virus and exposure to antiretroviral therapy (ART). HIV infection disrupts gut-associated lymphoid tissue (GALT), resulting in early depletion of CD4+ T cells and compromised mucosal barrier function. These alterations contribute to microbial translocation, chronic inflammation, and immune dysregulation, impacting overall immune competence and increasing susceptibility to opportunistic infections. Despite advances in ART, persistent immune activation and residual gut mucosal damage pose ongoing challenges in achieving optimal immune reconstitution and preventing long-term complications in HIV-exposed infants. Clinical implications of compromised gut mucosal immunity in HIV-exposed infants extend beyond gastrointestinal health to encompass systemic immune dysfunction and increased risks of non-AIDS comorbidities. Impaired gut barrier function exacerbates microbial translocation, leading to systemic inflammation that may contribute to neurodevelopmental abnormalities and metabolic disorders. Keywords: Gut, Immunity, HIV, Infants