People with HIV at risk of ageing-related genetic changes

Scientists from the Peter MacCallum Cancer Centre and the Kirby Institute at UNSW Sydney have uncovered a vital link in the relationship between HIV and ageing, with their results published in the journal Nature Medicine.

The research team evaluated age-related genetic changes in over 400 people — half with HIV and half without — from nine sites at hospitals and community practices. The study found people living with HIV had a higher rate of clonal haematopoiesis (CH), a condition common in older people and which results when a genetic mutation develops in a small number of blood stem cells.

“One in 10 older people in the general population have these mutations in their blood cells; however, our study found that one in five people with HIV have these mutations,” said Dr Nila Dharan from the Kirby Institute, co-lead author on the paper.

“As people with HIV have more cardiovascular disease and blood cancers than the general population, this finding suggests new pathways behind the development of medical conditions in people with HIV, and may in the future help identify preventive measures to reduce these conditions and optimise the health of ageing people with HIV.”

HIV attacks cells in the lymph nodes and in lymphatic tissue, and this causes inflammation. While HIV treatment slows this process, people with HIV may still have higher levels of inflammation than people without HIV.

“Our study found that people with HIV and CH had higher markers of inflammation, suggesting that the underlying chronic inflammation seen in people with HIV may create an environment that facilitates the emergence of clonal haematopoiesis mutations,” said Peter Mac’s Dr Paul Yeh, co-lead author on the paper.

“Because inflammation increases as part of the ageing process, older people with HIV may have multiple risk factors for the development of CH.”

The research casts new light on the biological processes occurring in people who are ageing with HIV, and outlines directions for future research. Dr Yeh said the study “demonstrated that people with HIV have an increased chance of developing clonal haematopoiesis mutations”, but noted that the team “did not find that people who have HIV and CH had more adverse health outcomes”.

Dr Yeh said there are many factors — such as age, gender and smoking — that determine whether a person develops stroke, cardiovascular disease or blood cancer, so further research is critical to understanding the role that CH plays.

“The question of HIV and premature ageing has been a longstanding area of research,” said Jane Costello, CEO of Positive Life NSW.

“The participation in this research by people living with HIV will have lasting positive impacts not only for ourselves, but the broader community as well.”

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