Aging and HIV Disease: Synergistic Immunological Effects?
The population of HIV-infected adults is progressively aging, due to more effective treatments that lower the viral load. Since aging and HIV disease each have major detrimental effects on the immune system, it is possible that in older persons who are infected with HIV-1, the immune changes due to the infection combined with those that occur with age may synergize to exacerbate the disease. Indeed, clinical studies have already documented older age as an independent risk factor for more rapid HIV disease progression. Moreover, immunological recovery in older individuals treated with antiretroviral drugs is less robust than in younger adults, even with equivalent levels of viral suppression. The challenge to future research will be to develop a detailed mechanistic understanding of the interplay between HIV-related and age-related immunological changes. This information will advance our theoretical understanding of the immune system and, at the same time, provide practical information regarding age-appropriate approaches to therapy and prophylactic vaccines.
KeywordsT cell Aging HIV/AIDS Telomere Telomerase Immunosenescence Cytomegalovirus
Much of the research on which this chapter is based has been supported by grants from the NIH (AG023720, AI060362 and AG032422) and by TA Therapeutics and the Geron Corporation. The author wishes to acknowledge all the MACS participants and the patients from the UCLA CARE Center. Our research would have been impossible to perform without their generous donation of blood samples. The work described in this chapter is based on over 20 years of research performed by members of my lab, in particular, Drs. Nancy Perillo, Carolyn Spaulding, Hector Valenzuela, Steven Fauce, Lucy Graham, Stanley Parish, Jennifer Chou, and Jeffrey Dock.
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