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Titanji BK. ARTful ageing: epigenetic rejuvenation in people with HIV. Lancet Healthy Longev 2023; 4:e181-e182. [PMID: 37148888 DOI: 10.1016/s2666-7568(23)00059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 05/08/2023] Open
Affiliation(s)
- Boghuma K Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA 30322, USA.
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Abstract
Effective and consistent antiretroviral therapy has enabled people with human immunodeficiency virus (HIV) (PWH) to survive longer than previously encountered earlier in the epidemic. Consequently, PWH are subject to the struggles and clinical conditions typically associated with aging. However, the aging process in PWH is not the same as for those who do not have HIV. There is a complex interplay of molecular, microbiologic, and pharmacologic factors that leads to accelerated aging in PWH; this leads to increased risk for certain age-related comorbidities requiring greater vigilance and interventions in routine care.
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Affiliation(s)
- Jason R Faulhaber
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Division of Infectious Diseases, 213 McClanahan St SW, Roanoke, VA 24014, USA.
| | - Anthony W Baffoe-Bonnie
- Virginia Tech Carilion School of Medicine, Carilion Clinic, Division of Infectious Diseases, 213 McClanahan St SW, Roanoke, VA 24014, USA
| | - Krisann K Oursler
- Virginia Tech Carilion School of Medicine, VA Salem Healthcare System, 1970 Roanoke Boulevard Salem, VA 24153-6404, USA
| | - Shikha S Vasudeva
- Virginia Tech Carilion School of Medicine, VA Salem Healthcare System, 1970 Roanoke Boulevard Salem, VA 24153-6404, USA
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Oursler KK, Marconi VC, Wang Z, Xu K, Montano M, So-Armah K, Justice AC, Sun YV. Epigenetic Age Acceleration Markers Are Associated With Physiologic Frailty and All-Cause Mortality in People With Human Immunodeficiency Virus. Clin Infect Dis 2023; 76:e638-e644. [PMID: 35970820 PMCID: PMC10169393 DOI: 10.1093/cid/ciac656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/02/2022] [Accepted: 08/10/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Biomarkers that provide insight into drivers of aging are needed for people with human immunodeficiency virus (PWH). The study objective was to determine if epigenetic age acceleration (EAA) markers are associated with physiologic frailty measured by the Veterans Aging Cohort Study (VACS) Index and predict all-cause mortality for PWH. METHODS Epigenome-wide DNA methylation was profiled in VACS total white blood cell samples collected during 2005-2007 from 531 PWH to generate 6 established markers of EAA. The association of each EAA marker was tested with VACS Index 2.0. All-cause mortality was assessed over 10 years. For each EAA marker, the hazard ratio per increased year was determined using Cox regression. To evaluate mortality discrimination, C-statistics were derived. RESULTS Participants were mostly men (98.5%) and non-Hispanic Black (84.4%), with a mean age of 52.4 years (standard deviation [SD], 7.8 years). Mean VACS Index score was 59.3 (SD, 16.4) and 136 deaths occurred over a median follow-up of 8.7 years. Grim age acceleration (AA), PhenoAA, HannumAA, and extrinsic epigenetic AA were associated with the VACS Index and mortality. HorvathAA and intrinsic epigenetic AA were not associated with either outcome. GrimAA had the greatest mortality discrimination among EAA markers and predicted mortality independently of the VACS Index. One-year increase in GrimAA was associated with a 1-point increase in VACS Index and a 10% increased hazard for mortality. CONCLUSIONS The observed associations between EAA markers with physiologic frailty and mortality support future research to provide mechanistic insight into the accelerated aging process and inform interventions tailored to PWH for promoting increased healthspan.
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Affiliation(s)
- Krisann K Oursler
- Department of Internal Medicine, Virginia Tech Carilion School of Medicine and Veterans Affairs Salem Healthcare System, Roanoke, Virginia, USA
| | - Vincent C Marconi
- Department of Medicine, Emory University School of Medicine and Rollins School of Public Health, Atlanta, Georgia, USA.,Veterans Affairs Atlanta Healthcare System, Decatur, Georgia, USA
| | - Zeyuan Wang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Ke Xu
- Department of Psychiatry, Yale School of Medicine, West Haven, Connecticut, USA.,Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Monty Montano
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Kaku So-Armah
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amy C Justice
- Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Medicine, Yale School of Medicine, West Haven, Connecticut, USA.,Division of Health Policy, Yale School of Public Health, West Haven, Connecticut, USA
| | - Yan V Sun
- Veterans Affairs Atlanta Healthcare System, Decatur, Georgia, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Abstract
Defective HIV-1 proviruses represent a population of viral genomes that are selected for by immune pressures, and clonally expanded to dominate the persistent HIV-1 proviral genome landscape. There are examples of RNA and protein expression from these compromised genomes which are generated by a variety of mechanisms. Despite the evidence that these proviruses are transcribed and translated, their role in HIV pathogenesis has not been fully explored. The potential for these genomes to participate in immune stimulation is particularly relevant considering the accumulation of cells harboring these defective proviruses over the course of antiretroviral therapy in people living with HIV. The expression of defective proviruses in different cells and tissues could drive innate sensing mechanisms and inflammation. They may also alter antiviral T cell responses and myeloid cell functions that directly contribute to HIV-1 associated chronic comorbidities. Understanding the impact of these defective proviruses needs to be considered as we advance cure strategies that focus on targeting the diverse population of HIV-1 proviral genomes.
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Affiliation(s)
- Jeffrey Kuniholm
- Department of Microbiology, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, 02116, USA
| | - Carolyn Coote
- Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, 02116, USA
| | - Andrew J Henderson
- Department of Microbiology, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, 02116, USA. .,Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, 02116, USA.
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Coghill AE, Dickey BL. Room to Grow: The Need for Cancer Site-Specific Research Into Biomarkers of Aging and Immunity in People With HIV. J Natl Cancer Inst 2022; 114:790-791. [PMID: 35292810 PMCID: PMC9194629 DOI: 10.1093/jnci/djac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/08/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Anna E Coghill
- Correspondence to: Anna E. Coghill, PhD, MPH, Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, 12092 USF Magnolia Dr, Tampa, FL 33612, USA (e-mail: )
| | - Brittney L Dickey
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
- Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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