title: Increased ocular lens density in HIV-infected individuals with low nadir CD4 counts in South Africa: evidence of accelerated aging.
abstract: BACKGROUND
  HIV infection is thought to be associated with an increased risk of age-related morbidity and premature aging. Lens density increases with age and may function as a biomarker of aging. The relationship of lens density measurements with clinical and demographic characteristics in HIV-infected individuals in comparison with a matched population of HIV-seronegative individuals was investigated.
  
  
  METHODS
  Case-control study of 490 adults aged greater than or equal to 30 years composed of 242 HIV-infected adults and 248 age- and sex-matched HIV-seronegative individuals. Lens density was assessed using lens densitometry (Pentacam) imaging. Measurements were divided into quartiles, and comparison of HIV status and HIV-related factors was assessed by multivariate and multinomial logistic regression.
  
  
  RESULTS
  The mean age was 41.2 years in HIV-infected adults and 42.3 years in HIV-seronegative individuals (P = 0.14). Of the HIV-infected adults, 88% were receiving antiretroviral therapy (ART) (median duration, 58 months), and within this group, their median CD4 count was 468 cells per microliter and 84% had undetectable viral load. Although adjusted lens densities were similar by HIV serostatus, participants on ART and who had nadir CD4 counts less than 200 cells per microliter had a higher risk of high lens density compared with HIV-seronegative individuals (P trend = 0.04). Lens density was weakly associated with detectable HIV viremia despite ART, but not with current CD4 count.
  
  
  CONCLUSIONS
  HIV-infected individuals on ART with nadir CD4 counts <200 cells per microliter had increased risk of higher lens density. Lens density may represent a novel biomarker of aging, providing insight into accelerated aging trajectories in HIV infection.
authors: International Center for Eye Health, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. sophia.pathai@lshtm.ac.uk
authors: Sophia
authors: S
authors: Pathai
authors: Stephen D
authors: SD
authors: Lawn
authors: Helen A
authors: HA
authors: Weiss
authors: Colin
authors: C
authors: Cook
authors: Linda-Gail
authors: LG
authors: Bekker
authors: Clare E
authors: CE
authors: Gilbert
mesh_terms: D000328:Adult; D000375:Aging; D019588:Aging, Premature; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D016022:Case-Control Studies; D002386:Cataract / Q000150:complications*; D003720:Densitometry; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000503:physiopathology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013019:South Africa / Q000453:epidemiology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D015415:Biomarkers