title: Cytomegalovirus, aging, and HIV: a perfect storm.
abstract: The success of highly active antiretroviral therapy in preventing progression of HIV-infected individuals to AIDS has greatly reduced the burden of opportunistic infections. Individuals with HIV infection are living longer, but as a group are at greater risk to develop age-related disorders, such as certain cancers, cardiovascular disease, type II diabetes, and cognitive impairment, at earlier ages than non-HIV-infected persons. This premature susceptibility to age-related morbidities reflects a syndrome referred to as accelerated aging, wherein deleterious features associated with aging emerge decades earlier in the setting of chronic HIV infection. A prominent immunological feature of accelerated aging in HIV infection is inflation of cytomegalovirus-specific memory T-cell responses to levels associated with an immune risk phenotype. In the absence of HIV infection, immune risk phenotypes develop in cytomegalovirus-infected octogenarians and signify some degree of immune senescence and an elevated risk for all-cause mortality. Chronic inflammation is a probable factor in health risks conveyed by the immune risk phenotype and in putative relationships between cytomegalovirus infection and the same set of age-related disorders arising in chronic HIV infection. Most HIV-infected individuals are cytomegalovirus-seropositive, both HIV and cytomegalovirus are associated with inflammation-related morbidities, and HIV infection accelerates the development of cytomegalovirus-dependent immunological abnormalities. Therefore, closer investigation of the relationship between cytomegalovirus and age-related morbidities emerging in chronic HIV infection appears warranted. This review summarizes evidence that cytomegalovirus could be an important cofactor in the development of age-related morbidities in HIV infection and discusses research to address underlying mechanisms.
authors: National Institutes of Health Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
authors: Lisa
authors: L
authors: Barrett
authors: Keith R
authors: KR
authors: Fowke
authors: Michael D
authors: MD
authors: Grant
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D000368:Aged; D000375:Aging / Q000276:immunology*; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D016922:Cellular Senescence / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load
chemical_list: D012367:RNA, Viral