Abstract

HIV infection during early life poses unique challenges to neonatal immune development, potentially leading to immune exhaustion and increased susceptibility to infections. This review explores the mechanisms and implications of HIV-induced immune exhaustion in neonates, focusing on the intricate interplay between viral pathogenesis, host immune responses, and developmental factors. We examine the impact of HIV infection on neonatal immune cell populations, including T cells, B cells, and myeloid cells, and discuss how viral persistence, immune dysregulation, and environmental factors contribute to immune exhaustion. Additionally, we explore the consequences of immune exhaustion in neonates, including impaired pathogen recognition, reduced vaccine responses, and increased risk of opportunistic infections. Understanding the mechanisms underlying HIV-induced immune exhaustion in neonates is essential for optimizing pediatric HIV care and developing targeted interventions to enhance immune function and improve outcomes in this vulnerable population.