Faculty of Science, School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.
Department of Medicine/Infectious Diseases, W.G. (Bill) Hefner VAMC, Salisbury, North Carolina.
J Gerontol A Biol Sci Med Sci. 2014 Jul;69(7):833-42. doi: 10.1093/gerona/glt168. Epub 2013 Oct 24.
Antiretroviral therapy has reduced the incidence of adverse events and early mortality in HIV-infected persons. Despite these benefits, important comorbidities that increase with age (eg, diabetes, cardiovascular disease, cancer, liver disease, and neurocognitive impairment) are more prevalent in HIV-infected persons than in HIV-uninfected persons at every age, and geriatric syndromes such as falls and frailty occur earlier in HIV-infected persons. This raises a critical research question: Does HIV accelerate aging through pathways and mechanisms common to the aging process or is HIV simply an additional risk factor for a wide number of chronic conditions, thus accentuating aging?
Extensive literature review.
The purpose of this review is to briefly outline the evidence that age-related clinical syndromes are exacerbated by HIV, examine the ways in which HIV is similar, and dissimilar from natural aging, and assess the validity of HIV as a model of premature aging. Specific biomarkers of aging are limited in HIV-infected hosts and impacted by antiretroviral therapy, and a high rate of modifiable life style confounders (eg, smoking, substance abuse, alcohol) and coinfections (eg, hepatitis) in HIV-infected participants.
There is a need for validated biomarkers of aging in the context of HIV. Despite these differences, welldesigned studies of HIV-infected participants are likely to provide new opportunities to better understand the mechanisms that lead to aging and age-related diseases.
抗逆转录病毒疗法降低了 HIV 感染者发生不良事件和早期死亡的风险。尽管有这些益处，但随着年龄增长而增加的重要合并症（如糖尿病、心血管疾病、癌症、肝病和神经认知障碍）在每个年龄段的 HIV 感染者中比 HIV 未感染者更为普遍，而在 HIV 感染者中，跌倒和虚弱等老年综合征发生得更早。这提出了一个关键的研究问题：HIV 是否通过与衰老过程共同的途径和机制加速衰老，还是 HIV 只是许多慢性疾病的另一个危险因素，从而加剧了衰老？
广泛的文献回顾。
本综述的目的是简要概述与年龄相关的临床综合征因 HIV 而加重的证据，检查 HIV 与自然衰老相似和不同的方式，并评估 HIV 作为早衰模型的有效性。HIV 感染宿主中特异性的衰老生物标志物有限，并受抗逆转录病毒治疗的影响，而且 HIV 感染者中存在大量可改变的生活方式混杂因素（如吸烟、药物滥用、酒精）和合并感染（如肝炎）。
在 HIV 背景下需要有经过验证的衰老生物标志物。尽管存在这些差异，但对 HIV 感染者进行精心设计的研究可能会为更好地理解导致衰老和与年龄相关疾病的机制提供新的机会。
