How does HIV affect the aging process?

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Silhouette Guerre soleilEducators 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 is truly the description / situation. HIV is not the only one in this respect, however. The immune system is constantly "at war" with a host of harmful organisms, for example viruses and bacteria that penetrate our bodies and with 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 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 cancer, but unchecked inflammation can cause absolute chaos over the body, causing the accumulation of heart attack and stroke risks, causing plaque in our arteries, fueling the growth of some cancers, and burning our immune system's resources.

We know from the earliest years of the epidemic that the immune systems of people with HIV get chronically inflamed, but prior to the introduction of the potent combination antiretroviral therapy (ART) at the end of the 1990 decade, most people with HIV died a lot young and very fast so that the long-term consequences of inflammation could be known. 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 produced some important results. We know that inflammation is significantly reduced in people who are able to get 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 therapy earlier. 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 treatment with ART.

While researchers are concerned about how inflammation directly affects large organs such as the heart, the liver13 and the 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, the more likely it is for the person to experience age-related immunosenescence, sometimes also called "immune exhaustion." This condition means that immune cells fail to react adequately when confronted 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, as the cells of HIV negative people decades older ...


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