Title

Ageing with grace with HIV

Code

SY22

Session Type

Symposium

Track

Cross-track

Format

Hybrid

CME accreditation

Yes

ROOM/CHANNEL

Room 517c/Channel 5

Date Time

31 July 14:15 - 15:15

Moderators

Pierre CORBEAU, CHU de Nimes; Institut de Génétique Humaine CNRS-Université de Montpellier, France
Alan LANDAY, Rush University Medical Center, United States

Chronic non-communicable age-related diseases increase as people living with HIV age. The harmful effect of HIV acquisition combined with persistent inflammation exacerbates immunometabolic changes and co-morbidities. Furthermore, people living with HIV are more exposed to other risk factors affecting ageing, like lifestyles and co-infections. The ART initiation reverses in part the biological ageing process, while adding drug toxicities that influence ageing. Furthermore, inflammation, immunometabolism, prediction of premature ageing through validated biomarkers, and imaging have clinical relevance for the development of biomedical, and psychological interventions for improving the life of people living with HIV. This session will highlight new mechanisms involved in HIV ageing and the clinical interventions ongoing in both developed and developing countries.

14:15 2 min	Introduction Pierre CORBEAU, CHU de Nimes; Institut de Génétique Humaine CNRS-Université de Montpellier, France Alan LANDAY, Rush University Medical Center, United States

14:17 12 min	Heart health and ageing on ART Cécile TREMBLAY, C.H.U.M., Canada	Slides

14:29 12 min	The coming of age of HIV geroscience Monty MONTANO, Harvard University, United States	Slides

14:41 12 min	The immune response against CMV links cellular to systemic senescence: Relevance for people living with HIV Michael GRANT, Memorial University Of Newfoundland and Labrador, Canada	Slides

14:53 12 min	HIV and ageing: Surmounting a double stigma Oluwafemi ADEAGBO, University of Johannesburg, South Africa	Slides

15:05 10 min	Q&A Pierre CORBEAU, CHU de Nimes; Institut de Génétique Humaine CNRS-Université de Montpellier, France Monty MONTANO, Harvard University, United States Michael GRANT, Memorial University Of Newfoundland and Labrador, Canada Cécile TREMBLAY, C.H.U.M., Canada Oluwafemi ADEAGBO, University of Johannesburg, South Africa Alan LANDAY, Rush University Medical Center, United States

AUTHOR

Sherazaan Ismail

SUMMARY

PLWH experience increasing age-related comorbidities. This effect is multifactorial, with HIV infection, co-infections, chronic inflammation and resultant immunometabolic changes, and stigma all exacerbating comorbidity risk. This session highlighted emerging mechanisms of aging in PLWH to identify potential interventions to increase quality of life in ageing PLWH.

HIGHLIGHTS

Dr. Cécile Tremblay (L’Université de Montréal) described their proposed model of CVD risk: gut damage and loss of CD4+ T cells in HIV infection results in the increase of IL-32 in PLWH, with subsequent migration of immune cells to plaques in the heart, increasing CVD risk. Dr. Monty Montano (Harvard University) presented that stressor and immune history contribute to ageing and can increase disease risk with age. Chronic inflammation, exacerbated by HIV infection, decreases NAD and mitochondrial function, resulting in skeletal muscle decline. In addition, other comorbidities further decrease metabolic function as a result of reduced NAD, resulting in a cascade of age-related decline. Dr. Michael Grant (Memorial University of Newfoundland and Labrador) reported on the inflation of CMV-specific cells (CD8+ T cells and NK cells) in PLWH. Indicators of more rapid immunological ageing in PLWH is evidenced by lower TREC in CD8+ T cells of CMV+ compared to CMV- PLWH, and shorter telomeres in CD8+ T cells than the total lymphocyte population. Dr. Oluwafemi Adeagbo (University of Johannesburg) highlighted how HIV stigma is compounded by ageism which leads to increased mortality and frailty in the ageing population of PLWH.

CRITICAL ASSESSMENT

There is evidence that the frequency of comorbidities in ageing PLWH is decreasing over time. This may be due to earlier diagnosis and treatment, adding to the evidence that early ART is imperative for reducing the effects of sustained inflammation. There is link between CMV coinfection and more rapid immunological ageing in PLWH. Studies are needed to determine whether antivirals to reduce the number of CMV reactivation occurrences in PLWH slow the immunological ageing process. Finally, tackling ageism in addition to HIV stigma may reduce barriers to accessing HIV care, reducing morbidity and frailty in ageing PLWH.