MECHANISMS OF ACCELERATED AGING IN GERIATRIC HIV+ SUBJECTS

This study will compare HIV+ to HIV- people of similar ages to see if chronic HIV infection allows microbes from the gut to enter the blood which, in turn, leads to chronic inflammation and other HIV-Associated Non-AIDS (HANA) conditions.

 

Background

 

Despite highly successful viral suppression, people who have been HIV+ a long time can have several HANA conditions including cardiovascular disease, lung disease, cancer, neurocognitive/neuropsychiatric problems, osteopenia/osteoporosis (bone loss), liver problems, and kidney disease. 

 

The causes and severity of the HANA conditions in older HIV+ people are poorly understood. Under normal circumstances, the immune response generates an inflammatory response that turns itself off when the threat is gone. However, when the immune system is confronted with an infection that it cannot clear – such as during chronic HIV infection, the inflammatory response persists and may even get amplified. This chronic inflammation can lead to many health problems such as sarcopenia (muscle loss), osteoporosis, and cardiovascular disease. Another hallmark of HIV infection is the depletion of gut lymphoid tissue, which in turn leads to breaches in the intestinal mucosal barrier and translocation of bacteria into the body causing inflammation. 

 

Study summary

 

We will enroll up to 200 subjects over the age of 55. Subjects will be divided into two groups based on their HIV status. We will collect health information, blood, and stool samples from all subjects to complete the study aims:

1. Investigate the impact of HIV and advanced age on bacterial translocation

2. Investigate the impact of HIV infection and advanced age on inflammation

3. Investigate the impact of HIV infection and advanced age on  quality of life for the elderly