Forty years after the first diagnosis of HIV/AIDS, scientists from Peter Mac and the Kirby Institute at UNSW Sydney have uncovered a vital link in the relationship between HIV and ageing.
The results were published today in the journal Nature Medicine.
In this world-leading study, the research team evaluated age-related genetic changes in over 400 people - half had HIV and the other half did not - from nine sites at hospitals and community practices.
The study found people living with HIV had a higher rate of clonal haematopoiesis (CH), a condition common in older people and which results when a genetic mutation develops in a small number of blood stem cells.
“One in ten older people in the general population have these mutations in their blood cells, however our study found that one in five people with HIV have these mutations,” says Dr Nila Dharan from the Kirby Institute, co-lead author on the paper.
“As people with HIV have more cardiovascular disease and blood cancers than the general population, this finding suggests new pathways behind the development of medical conditions in people with HIV, and may in the future help identify preventive measures to reduce these conditions and optimise the health of ageing people with HIV.”
An HIV diagnosis used to be a death sentence, but thanks to incredible scientific advances in antiretroviral treatments, people with HIV are living long, healthy lives.
“The good news is that globally, people with HIV are living longer, and the question of how HIV affects the ageing process, and what we can do to maximise the health and quality of life of older adults with HIV, is becoming an increasingly important field of research,” says Dr Dharan.
This discovery is centred around the relationship between HIV, inflammation, and ageing.
HIV attacks cells in the lymph nodes and in lymphatic tissue, and this causes inflammation.
While HIV treatment slows this process, people with HIV may still have higher levels of inflammation than people without HIV.
“Our study found that people with HIV and CH had higher markers of inflammation, suggesting that the underlying chronic inflammation seen in people with HIV may create an environment that facilitates the emergence of clonal haematopoiesis mutations,” says co-lead author on the paper, Peter Mac’s Dr Paul Yeh.
“Because inflammation increases as part of the ageing process, older people with HIV may have multiple risk factors for the development of CH.”
The research casts new light on the biological processes occurring in people who are ageing with HIV, and outlines directions for future research.
“Our research has demonstrated that people with HIV have an increased chance of developing clonal haematopoiesis mutations.
“Importantly, however, in this study we did not find that people who have HIV and CH had more adverse health outcomes, but more research is needed,” says Dr Paul Yeh.
Dr Yeh said there are many factors - such as age, gender and smoking - that determine whether a person develops stroke, cardiovascular disease or blood cancer so further research is critical to understanding the role that CH plays.
Ms Jane Costello, CEO of Positive Life NSW, said "the question of HIV and premature ageing has been a longstanding area of research”.
“The participation in this research by people living with HIV will have lasting positive impacts not only for ourselves but the broader community as well.”
Kirby Institute: Luci Bamford, 0432 894 029 - [email protected]
Peter MacCallum Cancer Centre: Danny Rose, 0417 123 048 - [email protected]
Positive Life NSW: Jane Costello, 1800 245 677 - [email protected]
MORE ABOUT THE ARCHIVE STUDY
The Age-Related Clonal haematopoiesis in an HIV Evaluation cohort – or ARCHIVE study - looks at genomic factors associated with ageing and the development of comorbidities among people with and without HIV over the age of 55 years living in the community.
The multidisciplinary team is led by Dr Nila Dharan and Associate Professors Mark Polizzotto and Kathy Petoumenos at the Kirby Institute, and Dr Paul Yeh and Professors Sarah-Jane Dawson and Mark Dawson at the Peter MacCallum Cancer Centre.
Participants were recruited through Holdsworth House Medical Practice, East Sydney Doctors, Prahran Market Clinic, St Vincent’s Hospital Sydney, Albion Centre, Alfred Hospital, Monash Health, Taylor Square Private Clinic, Sydney Local Health District.