To get a good understanding of this text, we recommend you take the topic at the beginning of this link: Aging and HIV
Educators often explain what happens in the body of people with HIV as a battle: the war between the virus and immune cells. Although too simple, this explanation is true. HIV is not unique in this regard, however. The immune system is constantly "at war" with a number of harmful organisms, for example the viruses and bacteria that penetrate our bodies and our own cells that become defective and begin to reproduce very quickly - what we call cancer .
Where HIV differs from many diseases is that in 99 percent of HIV-positive patients the immune system of people can not control the virus very well. This constant state of battle, where the virus reproduces and the body fights against it, keeps the immune system on high alert chronically, a syndrome called inflammation.
Inflammation is not intrinsically bad and this is something we need to combat infections such as bird flu, to repair damage to body tissues and to prevent the growth of certain types of cancers, but unchecked inflammation can cause absolute chaos on the body, causing heart attack and stroke, caused by fat plaques in our arteries, fueling the growth of some types of cancer, and the gradual loss of our immune system.
We know that since the early years of the epidemic the immune systems of people with HIV were chronically inflamed, but prior to the introduction of the combination of potent antiretroviral therapy (ART) at the end of the 1990 decade, most people with HIV died very young and very to know the long-term consequences of inflammation so that we can know them. Once ART became available, and people began to live much longer, scientists were finally able to study the long-term effects of inflammation in people living with HIV.
In the last decade, several studies have yielded some important results. We know that inflammation is significantly reduced in people who are able to reach and keep their viral loads undetectable by using ART. This is one of the reasons why the commission responsible for writing the HIV treatment guidelines of the Department of Health and Human Services (DHHS) recommends that people start HIV HAART as early as possible. Unfortunately, we have also learned that an undetectable viral load does not mean that the inflammation is completely blocked, which can still be detected, and can cause problems in people who would otherwise be responding well to ART.
While researchers are concerned about how inflammation directly affects large organs such as the heart, liver and kidneys, they are also interested in knowing how chronic inflammation affects the immune system itself. The longer a person's immune system continues to fight HIV - even if ART is being used and the more likely that person with that experience to have age-related immunosenescence, sometimes also called "immune exhaustion."
This condition means that immune cells fail to react properly when faced with a new challenge. They also do not reproduce easily and efficiently. In fact, when scientists have the immune cells of people with HIV, they find that these cells often have the same degree of attrition that, compared to the immune system of HIV-negative people, people with HIV are biologically many decades older older than the temporal age of these people.