NIAID Supports Research Towards Healthy Aging for People Living with HIV

Cross-posted from NIAID Now Blog

Today marks the 10^th National HIV/AIDS and Aging Awareness Day. This annual observance brings attention to the unique social and health-related challenges of older people living with and at risk for HIV. NIAID supports and collaborates on research that aims to both understand and mitigate long-term complications of HIV for men and women aging with HIV.

According to the Centers for Disease Control and Prevention, people aged 55 and older accounted for 26% of all Americans living with HIV infection in 2013—a demographic shift driven by the availability and success of antiretroviral therapy (ART) that prevents the onset of AIDS and extends lifespan. As more people living with HIV progress through their fifties, sixties, and beyond, the medical community continues to learn about how cardiovascular disease, memory problems, and other conditions associated with aging may differ in people living with HIV.

In the case of heart disease, NIAID-supported research found that people living with HIV are 50 to 100 percent more likely to develop cardiovascular disease than people without HIV. This elevated risk is thought to be a result of chronic inflammation, which can harden blood vessels over time and increase one’s chances of experiencing heart attack and stroke. To address the urgent need to prevent these life-threatening cardiovascular events in people living with HIV, the National Heart, Lung, and Blood Institute and NIAID launched the Randomized Trial to Prevent Vascular Events in HIV, or REPRIEVEExit Disclaimer, in 2015. The study aims to enroll 6,500 participants between the ages of 40 and 75 in over 100 sites in the United States and around the world to determine whether a daily dose of a cholesterol-lowering statin can reduce the risk of cardiovascular disease in people living with HIV who would not normally be prescribed a statin. Researchers will also evaluate how this effect may differ for women living with HIV in an embedded study called Follow YOUR HeartExit Disclaimer. Read more about the REPRIEVE study.

Older people living with HIV may also experience an increased risk of neurocognitive impairment, which can include memory problems, relative to their HIV-negative peers. Recent NIAID-supported researchExit Disclaimer presented at the 9^thInternational AIDS Society Conference on HIV Science found that, among older people living with HIV, higher HDL cholesterol levels may be associated with better cognitive performance than those with lower HDL cholesterol. Investigators at clinical sites across the United States screened 988 older adults living with HIV using cognitive tests and compared these results with their physical exams and medical history. Researchers found that 18 percent of participants had some form of neurocognitive impairment and that those who scored the highest on cognitive tests had higher HDL cholesterol and had been on ART longer than those with lower scores. The study participants were part of the AIDS Clinical Trials Group’s HIV Infection, Aging, and Immune Function Long-Term Observational Study, or HAILOExit Disclaimer. This NIAID-supported endeavor follows approximately 1,000 men and women over age 40 living with HIV to assess signs of aging-related issues, including problems with cognition, mobility, self-sufficiency and safety at home.

NIAID supports research to improve the health of those living with and at risk of acquiring HIV at every stage of life—from infancy, through adolescence to the final decades of life. The goal remains to preserve health by reducing and mitigating comorbidities for people living  with HIV. More information on HIV and aging is available at HIV.gov.

References:

M. Akintomiwa et al. Higher HDL, better brain? Higher HDL cholesterol is associated with better cognition in a cohort of older persons living with HIV infectionExit Disclaimer.  IAS 2017, Abstract 4357.