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Older people with HIV are twice as likely to develop ageing-related genetic changes

In breakthrough research, scientists have discovered that older people with HIV have a higher prevalence of genetic blood cell mutations. 

Researchers from the Kirby Institute found that 1 in 5 people living with HIV had ageing-related genetic changes, compared to the 1 in 10 found in older adults without HIV.

The phenomenon, known as clonal hematopoiesis, occurs when a genetic mutation develops in a small number of blood stem cells. It is linked to increased inflammation and higher risks of blood cancers and cardiovascular diseases.

“Our goal here was to test our hypothesis that people with HIV might have more of these mutations than people without HIV,” said co-lead author of the report Dr Nila Dharan.

“We weren’t expecting to find such a big difference, but we did find that they had about twice as many.”

Dr Dharan and her colleagues analysed blood samples and health information from older adults with HIV and compared it to data from the general population. 

Published in Nature Medicine last month, the findings give way to a clearer understanding of how older adults with HIV will experience ageing. Around 29,042 people currently live with the condition in Australia. 

“We certainly know that people with HIV have more medical comorbidities, things like high blood pressure, cardiovascular disease, diabetes — and there’s a lot of different reasons for this," said Dharan. 

“Interestingly, it looks like these mutations may have an advantage in an inflammatory environment.”

The extent to which increased exposure to genetic blood changes will impact quality of life and health in older adults with HIV will require a prolonged investigation in the future. 

There are no known warning signs or symptoms of the genetic blood cell changes, making early detection near impossible. 

“We’re still at the early stages now, meaning we’ve just discovered that HIV is a risk factor for these ageing-associated mutations," Dharan said.

“That means for people with HIV, the risk of having poor clinical outcomes or adverse effects of ageing relative to people who don’t have these mutations, is so great.”

The relationship between the ageing process and HIV is complex, as developing research has yet to paint a full picture of how the condition affects people in later life.

In Australia, nearly half of people with HIV are aged 55 and over. This figure is projected to rise as the population of older Australians increases. 

The country has seen significant reductions in the number of HIV diagnoses over recent years, with 813 cases recorded in 2018, the lowest number recorded in two decades.

Medical breakthroughs in treatment and prevention have made living longer with HIV possible. The introduction of the Pre-Exposure Prophylaxis, or PrEP, being one of the most notable recent developments 

“Studies have shown that the biological process of ageing in aged people with HIV seems to be faster, or they seem to at least age differently than people without HIV,” said Dharan.

“We all know that as you age, inflammation increases, and then with HIV, you also have elevated inflammation, even if it is very well controlled.”

Living with HIV at an advanced age is also associated with many cultural and social challenges, many which were highlighted during the recent royal commission.

Neglect, discrimination and a lack of awareness across the wider community were identified as key barriers currently facing Australians with HIV accessing the health system. 

In light of the recent scientific advances the chief executive of Positive life NSW, Jane Costello, remarked that the findings lead the way forward to developing a greater understanding of how people of older age will experience HIV. 

“The question of HIV and premature ageing has been a longstanding area of research,” she said. 

“The participation in this research by people living with HIV will have lasting positive impacts not only for ourselves but the broader community as well.” 

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