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Volume 17
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10.3390/v17030442
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Review

Understanding HIV-Exposed Uninfected Children: A Narrative Review

by
Martina Salvi
,
Benedetta Fioretti
,
Maria Alberti
,
Irene Scarvaglieri
,
Stefania Arsuffi
,
Giorgio Tiecco
,
Francesco Castelli
and
Eugenia Quiros-Roldan
*
Department of Clinical and Experimental Sciences, SD of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
*
Author to whom correspondence should be addressed.
Viruses 2025, 17(3), 442; https://doi.org/10.3390/v17030442
Submission received: 21 January 2025 / Revised: 12 March 2025 / Accepted: 18 March 2025 / Published: 19 March 2025
(This article belongs to the Section Human Virology and Viral Diseases)
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Abstract

The widespread implementation of antiretroviral therapy has significantly reduced HIV-related mortality and mother-to-child transmission. Despite being HIV-uninfected, HIV-exposed children (HEU) seem to face heightened risks of immune dysfunction, cardiometabolic diseases, growth delays, reduction in bone mineral density, and neurocognitive impairments compared to HIV-unexposed uninfected peers. These vulnerabilities can be attributed to maternal immune dysregulation during pregnancy, antiretroviral (ART) toxicity, HIV exposure, and adverse socioeconomic and nutritional environments. Emerging evidence highlights the impact of antiviral therapy exposure, particularly tenofovir disoproxil fumarate, on HEU mitochondrial dysfunction, bone resorption, neurocognitive delays, and zidovudine on cardiac abnormalities. This narrative review explores the multisystem effects of ART exposure in HEU children, focusing on immune function, neurodevelopment, cardiovascular health, growth, and bone metabolism. By synthesizing findings from diverse studies, the review aims to provide a comprehensive understanding of the potential risks associated with ART regimens and identify future research priorities to improve outcomes for HEU children.
Keywords: HIV-exposed uninfected children; HEU; HIV maternal exposure; cardiovascular; bone; growth; neurocognitive; inflammation HIV-exposed uninfected children; HEU; HIV maternal exposure; cardiovascular; bone; growth; neurocognitive; inflammation

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MDPI and ACS Style

Salvi, M.; Fioretti, B.; Alberti, M.; Scarvaglieri, I.; Arsuffi, S.; Tiecco, G.; Castelli, F.; Quiros-Roldan, E. Understanding HIV-Exposed Uninfected Children: A Narrative Review. Viruses 2025, 17, 442. https://doi.org/10.3390/v17030442

AMA Style

Salvi M, Fioretti B, Alberti M, Scarvaglieri I, Arsuffi S, Tiecco G, Castelli F, Quiros-Roldan E. Understanding HIV-Exposed Uninfected Children: A Narrative Review. Viruses. 2025; 17(3):442. https://doi.org/10.3390/v17030442

Chicago/Turabian Style

Salvi, Martina, Benedetta Fioretti, Maria Alberti, Irene Scarvaglieri, Stefania Arsuffi, Giorgio Tiecco, Francesco Castelli, and Eugenia Quiros-Roldan. 2025. "Understanding HIV-Exposed Uninfected Children: A Narrative Review" Viruses 17, no. 3: 442. https://doi.org/10.3390/v17030442

APA Style

Salvi, M., Fioretti, B., Alberti, M., Scarvaglieri, I., Arsuffi, S., Tiecco, G., Castelli, F., & Quiros-Roldan, E. (2025). Understanding HIV-Exposed Uninfected Children: A Narrative Review. Viruses, 17(3), 442. https://doi.org/10.3390/v17030442

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