Premature Aging Hits Longtime HIV+

The San Francisco Chronicle reports that some longtime HIV patients are experiencing symptoms of aging long before those ailments normally appear.  Such reports have been appearing for several years.

Patients are coming down with diseases and conditions most associated with aging even when their HIV is well controlled - even when the antiretroviral drugs used to treat it make the virus essentially undetectable in the blood, and by nearly all accounts a patient's immune system is strong and stable. They are having heart attacks and strokes in their 50s or 60s. They're developing dementia and arthritis a decade earlier than they should be. They're getting cancers that tend to strike only people in their 70s or 80s. "In the last 18 months, in my clinic I've had four people under age 60 who've had either bypass surgery or heart attacks," said Dr. Brad Hare, medical director of the HIV/AIDS ward at San Francisco General Hospital. "One of them was 37 years old. That's something that would be more typical in somebody 70 or older."

The primary culprit appears to be chronic inflammation brought on by latent copies of the virus that remain in the bloodstream even during anti-retroviral treatment.

It's been clear to scientists for some time that chronic inflammation is tied to aging, and especially to the decline in the immune system known as cellular senescence, the process by which the body loses cells critical to fighting infections. What's not clear is whether inflammation is a cause or effect of the deterioration of the immune system. Scientists have, in HIV patients and in the elderly, identified signs of both senescence and inflammation. And, in turn, they've noted a susceptibility to certain "old-age" diseases in both older patients and HIV-positive patients. But how those processes are causing disease isn't quite understood.

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