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Mechanisms controlling the persistence of infectious HIV reservoirs in children

Studies examine four mechanisms that could sustain the HIV reservoirs in children versus adults: (1) immune tolerance of HIV due to “perinatal” infection, and/or (2) “cross immune tolerance” to HIV generated by increased levels of maternal microchimerism (MMc); (3) modulation of gene expression by HIV integration in genes of Treg that promote survival of these cells impairing antiviral functions; and (4) by the persistent loss of gut T-helper (Th)17 cells due to bacterial translocation eliciting pro-inflammatory cytokines that favor the development and persistence of Tregs instead of effective antiviral CD4+ T-cell help.