Infection and telomere length: A systematic review.

Area of Science:

• Immunology and aging research
• Infectious diseases and public health

Background:

• Infections are implicated in age-related diseases like dementia.
• Accelerated immunological aging, measured by telomere length (TL), is a potential mechanism.
• The link between specific infections and TL or telomere attrition requires clarification.

Purpose of the Study:

• To systematically review existing literature on the association between infections and telomere length (TL) or telomere attrition.
• To identify research gaps and inform future studies on this relationship.

Main Methods:

• Comprehensive database searches (MEDLINE, EMBASE, Web of Science, Scopus, Global Health, Cochrane Library) were conducted.
• Studies were screened, data extracted, and risk of bias assessed using ROBINS-E.
• Due to heterogeneity, a narrative synthesis was performed, with evidence quality evaluated using GRADE.

Main Results:

• Of 10,349 identified studies, 73 met eligibility criteria; most were cross-sectional and published post-2000.
• Human Immunodeficiency Virus (HIV) was the most studied infection, with 79% of studies reporting an association with reduced TL or increased telomere attrition.
• Findings for other infections (e.g., herpesviruses) were variable, and most studies had high risk of bias, leading to a very low GRADE evidence quality rating.

Conclusions:

• A potential association exists between HIV and telomere length/attrition.
• More robust, longitudinal studies with standardized measurements and better confounder control are crucial, especially for non-HIV infections.
• PROSPERO registration ID: CRD42023444854.