New Research Provides Clarity on Questions of HIV-Related Accelerated Aging
It's long been questioned if living with HIV, or using antiretroviral therapy (ART) to manage the virus, causes accelerated aging, but new research might finally be giving some answers. Journalist Marlene Cimons at the Washington Post spoke with several leading HIV/AIDS researchers who agree: starting treatment as soon as possible after diagnosis can help avoid the age-related diseases that have been seen developing at higher rates and at earlier ages in people living with HIV.
Age-related conditions -- including heart, liver and kidney diseases, cancers, and bone fragility -- have often been observed more frequently in people living with HIV. However, researchers have long rebuffed that it is more the traditional risk factors, such as lack of access to routine preventative care, poor nutrition, stress and substance use habits, that influences this increase as opposed to the presence of the virus itself or the medication used to treat it.
Researchers surveyed earlier this month by the Washington Post added a critical dimension to the current understanding of accelerated aging: the longer someone living with HIV goes without beginning antiretroviral therapy, the worse these long-term health outcomes are likely to be. HIV targets -- and, at the same time, activates -- the immune system, the body's protection against pathogens. Once the immune system recognizes significant levels of the virus in the body, it never really stops fighting against it, even after levels are decreased using ART.
Dr. Carl Dieffenbach, director of the AIDS division at the National Institute of Allergy and Infectious Diseases, uses the metaphor of a fire truck to explain the link: "With most infectious invaders, the immune system responds and then is supposed to rest, like a fire engine waiting to come out when there is a fire to be fought. ... With HIV, those firetrucks keep driving around looking for fires, even when there are none." This prolonged immune response wears on the other biological systems, making the normal wear-and-tear on the body happen much faster in folks living with HIV.
The focus of this research on older people living with HIV is critical: although people living with HIV are living longer and healthier lives due to medical advances, older adults with HIV continue to experience worse health and psychosocial outcomes than their HIV-negative peers. Further, over half of all people living with HIV are 50 years or older, so the rates of comorbidities associated with delayed ART initiation could affect a significant proportion of people.
More research and funding need to be devoted to the unique challenges faced by long-term survivors, and AIDS United will continue to advocate for them to make both available.
[Note from TheBody: This article was originally published by AIDS United on Apr. 20, 2018. We have cross-posted it with their permission.]