title: Is HIV a model of accelerated or accentuated aging?
abstract: BACKGROUND
  Antiretroviral therapy has reduced the incidence of adverse events and early mortality in HIV-infected persons. Despite these benefits, important comorbidities that increase with age (eg, diabetes, cardiovascular disease, cancer, liver disease, and neurocognitive impairment) are more prevalent in HIV-infected persons than in HIV-uninfected persons at every age, and geriatric syndromes such as falls and frailty occur earlier in HIV-infected persons. This raises a critical research question: Does HIV accelerate aging through pathways and mechanisms common to the aging process or is HIV simply an additional risk factor for a wide number of chronic conditions, thus accentuating aging?
  
  
  METHODS
  Extensive literature review.
  
  
  RESULTS
  The purpose of this review is to briefly outline the evidence that age-related clinical syndromes are exacerbated by HIV, examine the ways in which HIV is similar, and dissimilar from natural aging, and assess the validity of HIV as a model of premature aging. Specific biomarkers of aging are limited in HIV-infected hosts and impacted by antiretroviral therapy, and a high rate of modifiable life style confounders (eg, smoking, substance abuse, alcohol) and coinfections (eg, hepatitis) in HIV-infected participants.
  
  
  CONCLUSIONS
  There is a need for validated biomarkers of aging in the context of HIV. Despite these differences, welldesigned studies of HIV-infected participants are likely to provide new opportunities to better understand the mechanisms that lead to aging and age-related diseases.
authors.affiliation: Faculty of Science, School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.
authors.forename: Sophia
authors.initials: S
authors.lastname: Pathai
authors.affiliation: Department of Medicine/Infectious Diseases, W.G. (Bill) Hefner VAMC, Salisbury, North Carolina.
authors.forename: Hendren
authors.initials: H
authors.lastname: Bajillan
authors.affiliation: Department of Immunology/Microbiology, Rush University Medical Center, Chicago, Illinois. FC Donders Chair, Division of Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Faculty of Science, Utrecht University, The Netherlands.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Landay
authors.affiliation: Section on Infectious Diseases, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: High
mesh_terms: D000375:Aging; D019588:Aging, Premature / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015415:Biomarkers; D015897:Comorbidity; D003586:Cytomegalovirus Infections / Q000150:complications; D004064:Digestive System / Q000276:immunology / Q000382:microbiology; D005123:Eye / Q000473:pathology / Q000503:physiopathology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008954:Models, Biological; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D015415:Biomarkers
keywords: AIDS; Biomarkers of aging; HIV; Immunosenescence; Multimorbidity