Antiretroviral Therapy Can Not Completely Restore Rapid Aging Seen In HIV

The world’s largest HIV population is aging rapidly in developed countries, estimating nearly 50% of the populations reported is above 50 years of age. Previously, era of antiretroviral therapy has been reported to decrease the mortality and increased the life expectancy of HIV patients, but whether it increase the aging process is a topic of conflict as HIV increases the systemic inflammation.

At the University of California – Los Angeles Health Sciences, a team of researchers investigated for the first time the potential link of  epigenetic changes (non-genetic), raid aging in cells, and the HIV. They stated that the associated with the epigenetic changes that suggest accelerated aging.

Furthermore, they revealed that the antiretroviral therapy given over two years was not able to completely restore” age-appropriate epigenetic patterns”, leaving patients more susceptible to aging-related illnesses, results published in the Pathogens and Immunity yesterday.

The human immunodeficiency virus (HIV) epidemic was first recognized in the USA in the early 1980s and shortly afterwards started reporting throughout the world, affecting the younger populations with devastating effects. In 1990s, the effective “combination antiretroviral therapy (cART)” became available, which was found to reduce the mortality.

Speculations are that HIV may accelerate the aging process which is defined as “the time-dependent functional decline that affects most living organisms.” One of the most common factors that accelerate the aging process, specifically in HIV populations, include, genetic instability, epigenetic alterations, abnormal hormonal system and signaling, compromised immune system, and chronic inflammation.

People living with HIV face multiple challenges as they age. One of the major challenges they face include possible accelerated aging and higher rates of co-morbidities such as cardiovascular disease. Most of them also develop symptoms associated with other diseases like geriatric syndromes and face frailty earlier than uninfected people.

According to a review, HIV patients who are on cART are less susceptible to face life-threatening acute illnesses but must confront issues related to the aging process. Therefore, in the study, researchers confirmed these speculations in terms of its relationship with epigenetic changes.

Source: HIV.gov

It was the first longitudinal study that conducted to elucidate the impact of treatment versus the contribution of HIV-infection, on the increasing of aging epigenetics – “external factors that affect the function of genes in this population of adults”.

Up to 15 individuals sick with HIV were recruited, heir DNA was extracted  at three time points: 6 to 12 months before initiating the antiretroviral therapy, 6 to 12 months post initiation of the therapy,  and, again, 18 to 24 months after being put on the therapy. Following these therapies, comparative analysis of DNA containing samples from 15 age-matched, non-HIV-infected individuals was conducted.

Results found that the changes in epigenetics may help in getting better explanation why even a successful antiretroviral therapy that was successful in treating HIV-infected adults, are still at an increased risk for the early development of many aging associated diseases.

However, study had some limitations, such as, small samples size and lack of integration of other risk factors in determining the aging process. Therefore, it emphasizes the need for a larger study to detect more subtle epigenetic changes caused by antiretroviral therapy.

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