Human Immunodeficiency Virus and Clonal Hematopoiesis

Area of Science:

• Hematology
• Immunology
• Oncology

Background:

• Antiretroviral therapies (ART) have increased life expectancy for people living with human immunodeficiency virus (HIV), leading to a rise in comorbidities like cardiovascular disease (CVD) and non-acquired immunodeficiency syndrome (AIDS)-defined malignancies.
• Clonal hematopoiesis (CH), the acquisition of somatic mutations in hematopoietic stem cells, is increasingly recognized as a risk factor for CVD and myeloid neoplasms.
• Epidemiologic studies indicate a higher prevalence of CH in people living with HIV (PLWH), suggesting a potential link between HIV infection and CH-related health issues.

Approach:

• This review synthesizes current literature on the association between CH and HIV infection.
• It explores the potential mechanisms linking HIV, CH, and increased CVD risk, focusing on inflammatory signaling.
• The review also examines the impact of CH on HIV control and the risk of progression to myeloid neoplasms within the PLWH population.

Key Points:

• PLWH exhibit a higher prevalence of CH, which is associated with an increased risk of cardiovascular disease.
• CH may contribute to poorer HIV infection control among PLWH.
• CH is linked to an elevated risk of myeloid neoplasms, such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), particularly in the context of HIV infection.

Conclusions:

• The bidirectional relationship between HIV and CH necessitates further investigation at the molecular level.
• Understanding these associations is crucial for improving long-term health outcomes for PLWH.
• More preclinical and prospective clinical studies are required to elucidate the complex interplay between HIV, CH, and associated comorbidities.