Aging with HIV

Guaraldi, Giovanni; Milić, Jovana; Mussini, Cristina

doi:10.1007/s11904-019-00464-3

Cited by 79 publications

(78 citation statements)

References 42 publications

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“…The prevalence of PWH over 50 years of age is increasing rapidly each year, and is predicted to increase from 28 to 73% by 2030 (Yang et al, 2019 ). There is growing evidence that the prevalence of comorbidities and other age-related conditions including geriatric syndromes, functional or neurocognitive problems, polypharmacy or social difficulties are higher in PWH than in their uninfected counterparts (Guaraldi et al, 2019 ; Winston and Spudich, 2020 ). Limited information is available regarding the optimal clinical management of older PWH (Chen et al, 2019 ; Guaraldi et al, 2019 ; Guo and Buch, 2019 ).…”

Section: Altered Waste Clearance and Abnormal Aging In Handmentioning

confidence: 99%

“…There is growing evidence that the prevalence of comorbidities and other age-related conditions including geriatric syndromes, functional or neurocognitive problems, polypharmacy or social difficulties are higher in PWH than in their uninfected counterparts (Guaraldi et al, 2019 ; Winston and Spudich, 2020 ). Limited information is available regarding the optimal clinical management of older PWH (Chen et al, 2019 ; Guaraldi et al, 2019 ; Guo and Buch, 2019 ). Chronic neuroinflammation has been associated with altered synaptic connectivity and BBB function, and with neuronal injury (Bandera et al, 2019 ; Guaraldi et al, 2019 ).…”

Section: Altered Waste Clearance and Abnormal Aging In Handmentioning

confidence: 99%

“…Limited information is available regarding the optimal clinical management of older PWH (Chen et al, 2019 ; Guaraldi et al, 2019 ; Guo and Buch, 2019 ). Chronic neuroinflammation has been associated with altered synaptic connectivity and BBB function, and with neuronal injury (Bandera et al, 2019 ; Guaraldi et al, 2019 ). In the CNS, age-associated neuroinflammation is also linked with impaired waste clearance (Cassol et al, 2014 ).…”

Section: Altered Waste Clearance and Abnormal Aging In Handmentioning

confidence: 99%

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Astrocytes, HIV and the Glymphatic System: A Disease of Disrupted Waste Management?

Tice¹,

McDevitt

Langford³

2020

Front. Cell. Infect. Microbiol.

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The discovery of the glial-lymphatic or glymphatic fluid clearance pathway in the rodent brain led researchers to search for a parallel system in humans and to question the implications of this pathway in neurodegenerative diseases. Magnetic resonance imaging studies revealed that several features of the glymphatic system may be present in humans. In both rodents and humans, this pathway promotes the exchange of interstitial fluid (ISF) and cerebrospinal fluid (CSF) through the arterial perivascular spaces into the brain parenchyma. This process is facilitated in part by aquaporin-4 (AQP4) water channels located primarily on astrocytic end feet that abut cerebral endothelial cells of the blood brain barrier. Decreased expression or mislocalization of AQP4 from astrocytic end feet results in decreased interstitial flow, thereby, promoting accumulation of extracellular waste products like hyperphosphorylated Tau (pTau). Accumulation of pTau is a neuropathological hallmark in Alzheimer's disease (AD) and is accompanied by mislocalization of APQ4 from astrocyte end feet to the cell body. HIV infection shares many neuropathological characteristics with AD. Similar to AD, HIV infection of the CNS contributes to abnormal aging with altered AQP4 localization, accumulation of pTau and chronic neuroinflammation. Up to 30% of people with HIV (PWH) suffer from HIV-associated neurocognitive disorders (HAND), and changes in AQP4 may be clinically important as a contributor to cognitive disturbances. In this review, we provide an overview and discussion of the potential contributions of NeuroHIV to glymphatic system functions by focusing on astrocytes and AQP4. Although HAND encompasses a wide range of neurocognitive impairments and levels of neuroinflammation vary among and within PWH, the potential contribution of disruption in AQP4 may be clinically important in some cases. In this review we discuss implications for possible AQP4 disruption on NeuroHIV disease trajectory and how HIV may influence AQP4 function.

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Section: Altered Waste Clearance and Abnormal Aging In Handmentioning

confidence: 99%

Section: Altered Waste Clearance and Abnormal Aging In Handmentioning

confidence: 99%

Section: Altered Waste Clearance and Abnormal Aging In Handmentioning

confidence: 99%

See 1 more Smart Citation

Astrocytes, HIV and the Glymphatic System: A Disease of Disrupted Waste Management?

Tice¹,

McDevitt

Langford³

2020

Front. Cell. Infect. Microbiol.

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“…HIV infection has an independent effect on the process of aging and contributes to increasing multimorbidity [ 3 ]. Whether due to acceleration (development of age-associated comorbidities at an earlier age compared with HIV-negative persons) or accentuation (increased age-associated comorbidities at similar ages compared with HIV-negative persons), prior studies found that older PWH are at risk of geriatric syndromes such as frailty, polypharmacy, and falls [ 4 ]. Consequently, multiple studies have recommended the Comprehensive Geriatric Assessment (CGA) in older PWH [ 4–6 ].…”

Section: Epidemiologymentioning

confidence: 99%

Comprehensive Geriatric Assessment in Older Persons With HIV

Sangarlangkarn

Appelbaum

2020

Open Forum Infectious Diseases

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With increased longevity related to the advent of antiretroviral therapy, there are increasing proportions of older persons living with HIV (PWH). Prior studies have demonstrated increased prevalence of geriatric syndromes in older PWH and recommended the Comprehensive Geriatric Assessments (CGA) in this population. However, there is currently no peer-reviewed literature that outlines how to perform CGA in PWH in the clinical setting. In this article, we offer a review on how to perform CGA in PWH, outline domains of the CGA and their importance in PWH, and describe screening tools for each domain focusing on tools that have been validated in PWH, are easy to administer, and/or are already commonly used in the field of geriatrics

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“…However, as some HIV-infected people do not know they have been infected with HIV (about 32.1% of HIV-infected people in China do not know their infection status), are lack of good compliance, have poor immune reconstitution, or have received organ transplants, their immunity is generally low and are prone to opportunistic infections or AIDS-related malignancies, and they need to be hospitalized for treatment and care. [1][2][3] At the same time, with the increase of the survival rate in people living with HIV (PLWH) , PLWH are facing with some new problems such as ,premature aging [4][5][6][7], increasing in biological age [8][9][10][11], frailty [12,13], multiple comorbidities [14][15][16][17][18]. Because of the serious condition, some patients also need to be hospitalized for treatment and care .…”

mentioning

confidence: 99%

Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

Shuai

Nie

Huang

et al. 2021

Preprint

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Objective: In China, the widespread use of Combination Antiretroviral Therapy(cART) has significantly improved the prognosis and quality of life in people living with HIV(PLWH). However, some PLWH still got worse and were hospitalized for some reasons, including AIDS-Defining Diseases(AD, such as opportunistic infections and AIDS-related Malignancies), Non-AIDS-Defining Diseases (NAD, such as non-AIDS-defining Malignancies and metabolic syndrome). At present, the age and disease of inpatients living with HIV(ILWH) are undergoing some significant changes. For example, the average age of ILWH is gradually increasing, the proportions of ILWH with NAD in all age groups are increasing, and the proportion of ILWH suffering from multiple types of NAD is increasing, which will have a greater impact to both ILWH and infectious disease hospitals. We aim to predict the changes in ILWH in the next 10 years, analyze the impact of such changes on ILWH and infectious disease hospitals in China, and propose corresponding countermeasures. Methods: We have established a prediction model based on Artificial Neural Network and Time series, using 12618 data of ILWH admitted to Chongqing Public Health Medical Center during 2010-2020, to predict the age of ILWH, the proportion of AD and NAD, the proportion of multiple types of NAD, and the proportion of NAD occurrences among various age groups from 2021 to 2030.Results: Our model shows that the average age of ILWH has risen from 43.8 years in 2010 to 57.6 years in 2030, and the increase in the age of women is greater than that of men. The number of ILWH in different age groups has changed significantly. Among them, the proportion of ILWH under 50 years old has gradually decreased, and the proportion of ILWH over 50 years old has gradually raised. By 2030, the proportion of inpatients over 50 years old will be close to 80%. The proportion of fatal opportunistic infections among ILWH has decreased year by year, and the most common diseases are tuberculosis-related diseases. The proportions of ILWH with only AD or NAD have gradually decreased, and the proportion of ILWH with both AD and NAD has increased year by year. It is estimated that the proportion of all ILWH with both AD and NAD will exceed 80% by 2030. Among all kinds of diseases in NAD, metabolic syndrome will have the highest rate of increase. By 2030, it will account for 16% in all ILWH. The proportion of hepatobiliary and pancreatic system diseases and blood system diseases in NAD will gradually decrease, while the proportion of metabolic syndrome, kidney disease, gastrointestinal disease, non-AIDS defining malignancies(NADM), bone disease and neurological diseases in NAD will gradually increase. The proportion of ILWH with NAD in all age groups will increase significantly after 10 years. Among them, the proportion of ILWH with NAD in 50-60 years old will be more than 80%, and among the ILWH under 30 years old, the proportion of ILWH suffering from NAD will increase to 69.6%. The proportion of ILWH without NAD or only 1 NAD will decrease, while the proportion of ILWH with 3 or more NAD will rise sharply. The proportion of ILWH with 1 type of NAD will drop to 12.6%, while the proportion of ILWH with 2 types of NAD, and the proportion of ILWH with 3 or more types of NAD will increase greatly. Conclusions: Significant changes have took place in the disease burden of ILWH in China, including the aging, the increase in the proportion of ILWH with NAD, and the increase in the proportion of ILWH with multiple types of NAD. These changes mean that in the next 10 years, the diagnosis, treatment and care of ILWH, as well as the development and construction of infectious disease hospitals will all face new challenges. This finding is based on a large number of long-term ILWH data in Chongqing, China, so we can consider that our research strategy can be promoted in China to improve the cure rate and quality of life in ILWH.

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Aging with HIV

Cited by 79 publications

References 42 publications

Astrocytes, HIV and the Glymphatic System: A Disease of Disrupted Waste Management?

Astrocytes, HIV and the Glymphatic System: A Disease of Disrupted Waste Management?

Comprehensive Geriatric Assessment in Older Persons With HIV

Future Challenges for Changes in the Disease Burden of Inpatients Living With HIV in China: a Predictive Study

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