Priorities for treating patients with HIV are changing.
The results of the research, which involved the use of a highly accurate biomarker to measure biological aging, are published in Molecular Cell.
HIV is a virus that, once acquired, never totally leaves the body.
Although there is no cure for HIV, antiretroviral therapy (ART), if correctly used, can keep the patient healthy and prolong the person's life to almost what it would have been without HIV.
Researchers from the University of Nebraska in Omaha, and the University of California in San Diego, teamed up to find out more about how chronic HIV infection affects aging.
The study involved 137 patients with HIV but no other health conditions that could bias the results. Participants were already enrolled in a long-term study to monitor people with HIV who are receiving combination antiretroviral therapy.
It involved a control group of 44 HIV-negative individuals. An independent group of 48 subjects, both HIV positive and negative, was used to confirm the findings.
Investigating methylation to uncover epigenetic changes
The team used a new tool to study epigenetic changes in people's cells. Epigenetic changes are those that alter the DNA but not the DNA sequence.
After these changes occur, they are passed down from one generation of cells to the next, influencing gene expression.
- Over 1.2 million people in the US live with HIV
- Almost 1 in 8, or 12.8%, are estimated to be unaware of their infection
- There are around 50,000 new infections each year.
The current research focused on methylation as a biomarker to show a specific epigenetic change. Methylation occurs when small chemical groups attach to the DNA, and it can affect how genes are translated into proteins.
Results suggest that HIV infection leads to an average advance in biological aging of 4.9 years, associated with a 19% increased risk of mortality.
Previous studies have shown that methylation alters across the genome as we age, explains co-author Trey Ideker, a professor of Genetics in the Department of Medicine at the University of California.
This is sometimes referred to as entropy or genetic drift. It remains unclear precisely how these changes give rise to the symptoms of aging, but it is possible to measure the changes within human cells.
The authors did not expect to see such a strong aging effect. They were also surprised to see that there was no difference between the methylation patterns in individuals who had been infected for under 5 years and those who had had the infection for more than 12 years.
Evolving needs in therapy for patients with HIV
Co-author Prof. Howard Fox, of the Department of Pharmacology and Experimental Neuroscience at the University of Nebraska Medical Center, says:
"The medical issues in treating people with HIV have changed. We're no longer as worried about infections that come from being immunocompromised. Now we worry about diseases related to aging, like cardiovascular disease, neurocognitive impairment and liver problems."
The authors believe that drugs could eventually be developed to target the kinds of epigenetic changes that affect this population group.
Meanwhile, the researchers call for greater awareness among people with HIV infection about the risk of developing age-related diseases. They urge patients to minimize the risks by making healthy lifestyle choices such as exercising regularly, maintaining a healthy diet and avoiding hazardous drug, alcohol and tobacco use.
Medical News Today recently reported that steps have been made toward developing a vaccine against HIV for people with no previous exposure to the infection.