Accelerated biological aging in HIV-infected individuals in South Africa: a case-control study.

Pathai, S; Lawn, SD; Gilbert, CE; McGuinness, D; McGlynn, L; Weiss, HA; Port, J; Christ, T; Barclay, K; Wood, R; Bekker, LG; Shiels, PG; (2013) Accelerated biological aging in HIV-infected individuals in South Africa: a case-control study. AIDS (London, England). ISSN 0269-9370 DOI:

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OBJECTIVES:: Little is known about the impact of HIV infection on biological aging in sub-Saharan Africa. The study aimed to assess biological aging in South African HIV-infected adults and HIV-seronegative individuals using two validated biomarkers, telomere length and CDKN2A expression (a mediator of cellular senescence). DESIGN:: Case-control study METHODS:: 236 HIV-infected adults aged ≥30 years and 250 age- and gender frequency-matched HIV-seronegative individuals were recruited from clinics in township communities in Cape Town. Biological aging was evaluated by measurement of telomere length and CDKN2A expression in peripheral blood leukocytes. RESULTS:: The median ages of the HIV-infected and HIV-seronegative participants were 39 years and 40 years respectively. Among HIV-infected participants, 87.1% were receiving anti-retroviral therapy (ART), their median CD4 count was 468 cells/μL and 84.3% had undetectable viral load. Both biomarkers were validated against chronological age in HIV-seronegative individuals. Telomere length was significantly shorter in HIV-infected individuals compared to HIV-seronegative individuals (mean relative T/S ratio±SE:0.91 ± 0.007 vs. 1.07 ± 0.008, p < 0.0001). CD2NKA expression was higher in HIV-infected participants compared to HIV-seronegative individuals (mean expression: 0.45 ± 0.02 vs. 0.36 ± 0.03, p = 0.003). Socio-economic factors were not associated with biological aging in HIV-infected participants. However, in participants on ART with undetectable viral load, biomarker levels indicated greater biological aging in those with lower current CD4 counts. CONCLUSIONS:: Telomere length and CDKN2A expression were both consistent with increased biological aging in HIV-infected individuals. Prospective studies of the impact of HIV on biological aging in sub-Saharan Africa are warranted.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Tropical Epidemiology Group
International Centre for Eye Health
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 23751258
Web of Science ID: 326706100006


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