Biological ageing with HIV infection: evaluating the geroscience hypothesis

Area of Science:

• Gerontology
• HIV Medicine
• Immunology

Background:

• People with HIV (human immunodeficiency virus) experience accelerated aging and are disproportionately affected by multimorbidity, especially in resource-limited settings.
• The geroscience hypothesis links aging hallmarks to multimorbidity, but these have not been systematically studied in the context of HIV.
• Understanding these aging processes is crucial for improving long-term health outcomes in the aging HIV population.

Purpose of the Study:

• To investigate key hallmarks of biological aging (gerodrivers) in people with HIV.
• To explore factors promoting healthy aging (geroprotectors) that counteract aging drivers.
• To propose a conceptual model integrating aging processes and protective mechanisms in HIV.

Main Methods:

• Examination of four major aging hallmarks: macromolecular damage, cellular senescence, inflammation, and stem cell dysfunction.
• Introduction of concepts like healthy aging, physiological reserve, intrinsic capacity, and resilience as geroprotective factors.
• Review of emerging geroscience-based biomarkers and therapeutic strategies, including non-pharmacological approaches.

Main Results:

• Identified specific aging hallmarks that are relevant gerodrivers in people with HIV.
• Highlighted the role of healthy aging, physiological reserve, intrinsic capacity, and resilience as crucial geroprotectors.
• Discussed potential diagnostic biomarkers and therapeutic interventions informed by geroscience.

Conclusions:

• Aging hallmarks significantly contribute to multimorbidity in people with HIV.
• Geroprotective strategies are essential to counteract aging drivers and promote healthy aging in this population.
• A comprehensive model integrating aging drivers and protectors can guide future research and clinical practice for aging with HIV.