title: HIV Infection Is Associated with Shortened Telomere Length in Ugandans with Suspected Tuberculosis.
abstract: BACKGROUND
  HIV infection is a risk factor for opportunistic pneumonias such as tuberculosis (TB) and for age-associated health complications. Short telomeres, markers of biological aging, are also associated with an increased risk of age-associated diseases and mortality. Our goals were to use a single cohort of HIV-infected and HIV-uninfected individuals hospitalized with pneumonia to assess whether shortened telomere length was associated with HIV infection, TB diagnosis, and 2-month mortality.
  
  
  METHODS
  This was a sub-study of the IHOP Study, a prospective observational study. Participants consisted of 184 adults admitted to Mulago Hospital in Kampala, Uganda who underwent evaluation for suspected TB and were followed for 2 months. Standardized questionnaires were administered to collect demographic and clinical data. PBMCs were isolated and analyzed using quantitative PCR to determine telomere length. The association between HIV infection, demographic and clinical characteristics, and telomere length was assessed, as were the associations between telomere length, TB diagnosis and 2-month mortality. Variables with a P≤0.2 in bivariate analysis were included in multivariate models.
  
  
  RESULTS
  No significant demographic or clinical differences were observed between the HIV-infected and HIV-uninfected subjects. Older age (P<0.0001), male gender (P = 0.04), total pack-years smoked (P<0.001), alcohol consumption in the past year (P = 0.12), and asthma (P = 0.08) were all associated (P≤0.2) with shorter telomere length in bivariate analysis. In multivariate analysis adjusting for these five variables, HIV-positive participants had significantly shorter telomeres than HIV-negative participants (β = -0.0621, 95% CI -0.113 to -0.011, P = 0.02). Shortened telomeres were not associated with TB or short-term mortality.
  
  
  CONCLUSIONS
  The association between HIV infection and shorter telomeres suggests that HIV may play a role in cellular senescence and biological aging and that shorter telomeres may be involved in age-associated health complications seen in this population. The findings indicate a need to further research the impact of HIV on aging.
authors.affiliation: Division of HIV/AIDS, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Auld
authors.affiliation: Department of Biophysics and Biochemistry, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Jue
authors.initials: J
authors.lastname: Lin
authors.affiliation: Division of HIV/AIDS, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.|Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Emily
authors.initials: E
authors.lastname: Chang
authors.affiliation: Makerere University - University of California, San Francisco (MU-UCSF) Research Collaboration, Kampala, Uganda.
authors.forename: Patrick
authors.initials: P
authors.lastname: Byanyima
authors.affiliation: Makerere University - University of California, San Francisco (MU-UCSF) Research Collaboration, Kampala, Uganda.
authors.forename: Irene
authors.initials: I
authors.lastname: Ayakaka
authors.affiliation: Makerere University - University of California, San Francisco (MU-UCSF) Research Collaboration, Kampala, Uganda.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Musisi
authors.affiliation: Makerere University - University of California, San Francisco (MU-UCSF) Research Collaboration, Kampala, Uganda.|Department of Medicine, Mulago Hospital, Makerere University, Kampala, Uganda.
authors.forename: William
authors.initials: W
authors.lastname: Worodria
authors.affiliation: Department of Pulmonary, Critical Care & Sleep Medicine, Yale University, New Haven, Connecticut, United States of America.
authors.forename: J Lucian
authors.initials: JL
authors.lastname: Davis
authors.affiliation: Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Mark
authors.initials: M
authors.lastname: Segal
authors.affiliation: Department of Biophysics and Biochemistry, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Blackburn
authors.affiliation: Division of HIV/AIDS, Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.|Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.|Makerere University - University of California, San Francisco (MU-UCSF) Research Collaboration, Kampala, Uganda.
authors.forename: Laurence
authors.initials: L
authors.lastname: Huang