Perinatally Acquired HIV: Viral Evolution and its Implications for Adolescents

Abstract

This literature review explores the implications of viral evolution on the health outcomes of adolescents with perinatally acquired HIV, offering recommendations for enhancing public health practices. Since the emergence of HIV in the 1980s, perinatal transmission from parent to child has become increasingly prevalent in developing countries. Antiretroviral therapy (ART) has greatly improved the life expectancy of children with perinatally acquired HIV, allowing them to reach adolescence. ART plays a critical role in suppressing HIV and reducing the risk of transmission. Nevertheless, low adherence or lack of treatment can lead to viral evolution and drug resistance, posing significant threats to adolescents. Challenges faced by adolescents with perinatally acquired HIV are multifaceted, including increased viral evolution and difficulties in adhering to ART. The impact of stigma, behavioral factors, and social and familial dynamics contribute to low adherence rates. Global inequities and systems-level challenges further complicate the situation, particularly in resource-limited settings. Adequate public health infrastructure and innovative approaches, such as long-acting injectable ART, are imperative to address these structural barriers and reduce drug resistance among adolescents. Comprehensive data collection and longitudinal studies are needed to understand the long-term consequences of perinatally acquired HIV and its impact on viral evolution. A multidisciplinary approach involving healthcare providers, virologists, and social scientists is crucial to meeting global HIV goals and addressing the specific needs of this vulnerable population.