Research on reducing the impact of aging
It is true that as people age, their immune systems (and other organs) decline. HIV infection itself does apparently prematurely age the immune system. However, potent combination anti-HIV therapy (commonly called ART or HAART) is able to help the immune system partially correct defects caused by HIV infection. This partial correction is sufficient, at least in people who respond to ART, to make many AIDS-related infections now a relatively rare occurrence in high-income countries. It may be that if ART is started very soon after HIV infection occurs, it could help prevent some of HIV’s detrimental effects on the immune system. Specifically, it may be able to prevent HIV-associated aging (shortening telomeres) of the immune system. This is something that needs to be explored in clinical trials.
One team of scientists that studies aging and telomere length in HIV-negative people notes that “a number of physiologic and/or psychological factors have an impact on overall health as well as effect on telomere length [in cells of the immune system].”
Several studies have found an association between shortened telomeres and the following:
- sustained stress
- major depression
A team of Canadian researchers has found that substance use—tobacco smoking and exposure to street drugs—appears to age the immune systems of HIV-positive women.
Observational studies have found that the following factors may lengthen telomeres in HIV-negative people:
- regular exercise
- maintaining a healthy weight
- eating more fruit and vegetables
- quitting smoking
- engaging in activities to help reduce the negative effects of stress, such as meditation and yoga
Emerging research suggests the possibility that eating a diet rich in omega-3 fatty acids (found in relatively large amounts in wild salmon, anchovies and sardines) may play a role in reducing inflammation and maintaining telomere length.
Until studies in HIV-positive people are done, the impact of these activities on their telomeres is not clear. What is clear is that taking ART, engaging in healthy activities (see above list), practising safer sex to reduce exposure to herpes viruses (some studies suggest that such viruses play a role in aging) and, where necessary, getting help and support for recovery from depression and addiction(s) are likely to enable HIV-positive people to stay healthy, reduce their risks for many illnesses and improve their quality of life.
—Sean R. Hosein
- Weng NP. Telomeres and immune competency. Current Opinion in Immunology. 2012 Aug;24(4):470-5.
- Imam T, Jitratkosol MH, Soudeyns H, et al. Leukocyte telomere length in HIV-infected pregnant women treated with antiretroviral drugs during pregnancy and their uninfected infants. Journal of Acquired Immune Deficiency Syndromes. 2012 Aug 15;60(5):495-502.
- Pawelec G, McElhaney JE, Aiello AE, et al. The impact of CMV infection on survival in older humans. Current Opinion in Immunology. 2012 Aug;24(4):507-11.
- Derhovanessian E, Theeten H, Hähnel K, et al. Cytomegalovirus-associated accumulation of late-differentiated CD4 T-cells correlates with poor humoral response to influenza vaccination. Vaccine. 2013 Jan 11;31(4):685-90.
- Chen S, Jm de Craen A, Raz Y, et al. Cytomegalovirus seropositivity is associated with glucose regulation in the oldest old. Results from the Leiden 85-plus Study. Immunity & Ageing. 2012 Aug 28;9(1):18.
- Lichtfuss GF, Cheng WJ, Farsakoglu Y, et al. Virologically suppressed HIV patients show activation of NK cells and persistent innate immune activation. Journal of Immunology. 2012 Aug 1;189(3):1491-9.
- Deeks SG, Verdin E, McCune JM. Immunosenescence and HIV. Current Opinion in Immunology. 2012 Aug;24(4):501-6.
- Cavanagh MM, Weyand CM, Goronzy JJ. Chronic inflammation and aging: DNA damage tips the balance. Current Opinion in Immunology. 2012 Aug;24(4):488-93.
- Hearps AC, Maisa A, Cheng WJ, et al. HIV infection induces age-related changes to monocytes and innate immune activation in young men that persist despite combination antiretroviral therapy. AIDS. 2012 Apr 24;26(7):843-53.
- Choi J, Fauce SR, Effros RB. Reduced telomerase activity in human T lymphocytes exposed to cortisol. Brain, Behavior and Immunity. 2008 May;22(4):600-5.
- Epel ES, Blackburn EH, Lin J, et al. Accelerated telomere shortening in response to life stress. Proceedings of the National Academy of Sciences USA. 2004 Dec 7;101(49):17312-5.
- Weng NP, Akbar AN, Goronzy J. CD28(-) T cells: their role in the age-associated decline of immune function. Trends in Immunology. 2009 Jul;30(7):306-12.
- Brydon L, Lin J, Butcher L, et al. Hostility and cellular aging in men from the Whitehall II cohort. Biological Psychiatry. 2012 May 1;71(9):767-73.
- Steptoe A, Hamer M, Butcher L, et al. Educational attainment but not measures of current socioeconomic circumstances are associated with leukocyte telomere length in healthy older men and women. Brain, Behaviour and Immunity. 2011 Oct;25(7):1292-8.
- Dowd JB, Bosch JA, Steptoe A, et al. Cytomegalovirus is associated with reduced telomerase activity in the Whitehall II cohort. Experimental Gerontology. 2013; in press.
- Lavretsky H, Epel ES, Siddarth P, et al. A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity. International Journal of Geriatric Psychiatry. 2013 Jan;28(1):57-65.
- Farzaneh-Far R, Lin J, Epel ES, et al. Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease. JAMA. 2010 Jan 20;303(3):250-7.
- Kiecolt-Glaser JK, Epel ES, Belury MA, et al. Omega-3 fatty acids, oxidative stress, and leukocyte telomere length: A randomized controlled trial. Brain, Behaviour and Immunity. 2013 Feb;28:16-24.