Biomarkers of aging in HIV: inflammation and the microbiome

Abstract

PurposeHIV-infected subjects present increased levels of inflammatory cytokines and T-cell activation in the peripheral blood despite suppressive combination antiretroviral therapy which renders them at increased risk of premature aging. The purpose of the present work is to review existing evidence on the ways in which the anatomical and microbiological abnormalities of the gastrointestinal tract can represent a major cause of organ disease in HIV infection. MethodsWe conducted a systematic review of the Pubmed database for articles published from 2014 to 2018. We included studies on inflammatory/activation biomarkers associated with cardiovascular and bone disease, neurocognitive impairment and serious non-AIDS events in HIV-infected subjects. We also included researches which linked peripheral inflammation/activation to the anatomical, immune and microbiological alterations of the gastrointestinal tract. Results Recent literature data confirm the association between non-infectious comorbidities andinflammation in HIV infection which may be driven by gastrointestinal tract abnormalities, specifically microbial translocation and dysbiosis. Furthermore, there is mounting evidence on the possible role of metabolic functions of the microbiota in the pathogenesis of premature aging in the HIV-infected population ConclusionsBiomarkers need to be validated for their use in the management of HIV infection. Compounds which counteract microbial translocation, inflammation and dysbiosis have been investigated as alternative therapeutic strategies in viro-suppressed HIV-infected individuals, but appear to have limited efficacy, probably due to the multifactorial pathogenesis of non-infectious comorbidities in this setting.3

Factors Associated with Periodontitis in Patients with and without HIV

“…Despite the benefits of antiretroviral therapy, treatment does not fully restore the immune system and has been associated with adverse effects such as increased markers of premature aging [ 10 , 11 ], residual chronic inflammation [ 12 , 13 ], bone mineral loss [ 14 ], and oral and intestinal dysbiosis [ 15 , 16 ], these changes could justify a possible explanation for the high rate of periodontitis in our sample with HIV. Unfortunately, we could not analyze inflammatory markers or oral microbiomes in our sample, due to the high cost of these techniques, especially when studying a large sample of 200 participants.…”

“…Despite the benefits of antiretroviral therapy, the treatment does not completely restore the immune system and has been associated with adverse effects such as increased markers of premature aging [ 10 , 11 ], residual chronic inflammation [ 12 , 13 ], bone mineral loss [ 14 ], and oral and intestinal dysbiosis [ 15 , 16 ]. Nonetheless, in the context of HAART, it appears that there has been a change in the profile of HIV-related diseases, and the presence of the virus is now associated with the exacerbation of chronic inflammatory diseases and disorders linked to aging [ 17 ].…”