Authors: Dr. Priya Sharma, Dr. Aarav Mehta
ABSTRACT: Chronic viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are characterized by persistent viral replication and impaired immune responses. A critical determinant of this impaired immunity is T-cell exhaustion, a state of functional hyporesponsiveness of virus-specific T cells due to prolonged antigenic stimulation. This paper reviews the mechanisms underlying T-cell exhaustion, including inhibitory receptor upregulation, transcriptional and epigenetic reprogramming, and metabolic alterations. The immunological consequences of exhaustion, including impaired cytokine production, reduced proliferative capacity, and diminished cytotoxic function, are discussed. Therapeutic strategies to reverse T-cell exhaustion, such as immune checkpoint blockade, therapeutic vaccines, and metabolic interventions, are explored. Tables summarizing key markers of exhaustion, affected viral infections, and potential therapeutic approaches are provided. Understanding T-cell exhaustion is essential for designing effective immunotherapies and improving outcomes in chronic viral infections.
KEYWORDS: T-cell exhaustion, Chronic viral infections, Immune checkpoint, HBV, HCV, HIV, Cytokine dysfunction, Immunotherapy
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