Background:  HIV infection has had a profound effect on the average life expectancy of adolescents and young adults in the countries most affected by the worldwide pandemic. This presentation examines the influence of age on immune function in health and disease and on immune reconstitution in adolescents and young adults during ART. In addition, we will review recent studies of the immune status of adult survivors of HIV infection acquired by mother-to-child transmission or from perinatal exposure to contaminated blood products. We will particularly emphasize data regarding thymic function and thymic dependant pathways of T cell regeneration in these young people. 

Conclusions:  These data may inform discussions with individual patients about the benefits of ART, and projections of the demographic effect on ART in countries heavily affected by the pandemic.