Nasi M, De Biasi S, Gibellini L, Bianchini E, Pecorini S, Bacca V, Guaraldi G, Mussini C, Pinti M, Cossarizza A
Department of Surgery, Medicine, Dentistry and Morphological Sciences, Modena, Italy.
Department of Life Sciences, Modena, Italy.
Clin Exp Immunol. 2017 Jan;187(1):44-52. doi: 10.1111/cei.12814. Epub 2016 Aug 9.
Nowadays, HIV patients have an expected lifespan that is only slightly shorter than healthy individuals. For this reason, along with the fact that infection can be acquired at a relatively advanced age, the effects of ageing on HIV people have begun to be evident. Successful anti-viral treatment is, on one hand, responsible for the development of side effects related to drug toxicity; on the other hand, it is not able to inhibit the onset of several complications caused by persistent immune activation and chronic inflammation. Therefore, patients with a relatively advanced age, i.e. aged more than 50 years, can experience pathologies that affect much older citizens. HIV individuals with non-AIDS-related complications can thus come to the attention of clinicians because of the presence of neurocognitive disorders, cardiovascular diseases, metabolic syndrome, bone abnormalities and non-HIV-associated cancers. Chronic inflammation and immune activation, observed typically in elderly people and defined as 'inflammaging', can be present in HIV patients who experience a type of premature ageing, which affects the quality of life significantly. This relatively new condition is extremely complex, and important factors have been identified as well as the traditional behavioural risk factors, e.g. the toxicity of anti-retroviral treatments and the above-mentioned chronic inflammation leading to a functional decline and a vulnerability to injury or pathologies. Here, we discuss the role of inflammation and immune activation on the most important non-AIDS-related complications of chronic HIV infection, and the contribution of aging per se to this scenario.
如今，艾滋病患者的预期寿命仅比健康个体略短。因此，再加上感染可能在相对高龄时发生，衰老对艾滋病患者的影响已开始显现。一方面，成功的抗病毒治疗会导致与药物毒性相关的副作用；另一方面，它无法抑制由持续的免疫激活和慢性炎症引起的多种并发症的发生。所以，年龄相对较大（即50岁以上）的患者可能会出现影响年长者的病症。患有非艾滋病相关并发症的艾滋病患者可能会因出现神经认知障碍、心血管疾病、代谢综合征、骨骼异常和非艾滋病相关癌症而引起临床医生的关注。慢性炎症和免疫激活通常在老年人中出现，被定义为“炎症衰老”，在经历一种影响生活质量的早衰类型的艾滋病患者中也可能存在。这种相对较新的情况极其复杂，除了传统的行为风险因素外，重要因素已被确定，例如抗逆转录病毒治疗的毒性以及上述导致功能衰退和易受伤或患病的慢性炎症。在此，我们讨论炎症和免疫激活在慢性艾滋病感染最重要的非艾滋病相关并发症中的作用，以及衰老本身对这种情况的影响。
