Centre for Biomedical Research, Burnet Institute, GPO Box 2248, Melbourne, VIC, 3001, Australia,
Curr HIV/AIDS Rep. 2014 Mar;11(1):20-34. doi: 10.1007/s11904-013-0190-8.
Increased life expectancy due to improved efficacy of cART has uncovered an increased risk of age-related morbidities in HIV+ individuals and catalyzed significant research into mechanisms driving these diseases. HIV infection increases the risk of non-communicable diseases common in the aged, including cardiovascular disease, neurocognitive decline, non-AIDS malignancies, osteoporosis, and frailty. These observations suggest that HIV accelerates immunological ageing, and there are many immunological similarities with the aged, including shortened telomeres, accumulation of senescent T cells and altered monocyte phenotype/function. However, the most critical similarity between HIV+ individuals and the elderly, which most likely underpins the heightened risk of non-communicable diseases, is chronic inflammation and associated immune activation. Here, we review the similarities between HIV+ individuals and the aged regarding the pathogenesis of inflammatory diseases, the current evidence for mechanisms driving these processes and discuss current and potential therapeutic strategies for addressing inflammatory co-morbidity in HIV+ infection.
由于 cART 疗效的提高，预期寿命延长，这使得 HIV 感染者出现与年龄相关的疾病的风险增加，并促使人们对导致这些疾病的机制进行了大量研究。HIV 感染会增加老年人常见的非传染性疾病的风险，包括心血管疾病、神经认知能力下降、非艾滋病相关恶性肿瘤、骨质疏松症和脆弱。这些观察结果表明，HIV 加速了免疫衰老，并且与衰老存在许多免疫学上的相似之处，包括端粒缩短、衰老 T 细胞的积累以及单核细胞表型/功能的改变。然而，HIV 感染者与老年人之间最关键的相似之处，可能是导致非传染性疾病风险增加的原因，是慢性炎症和相关的免疫激活。在这里，我们回顾了 HIV 感染者与老年人在炎症性疾病发病机制方面的相似之处，讨论了驱动这些过程的机制的现有证据，并讨论了针对 HIV 感染中炎症合并症的当前和潜在治疗策略。
