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Current HIV/AIDS Reports

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01.03.2014 | HIV Pathogenesis and Treatment (AL Landay, Section Editor)

Inflammatory Co-morbidities in HIV+ Individuals: Learning Lessons from Healthy Ageing

verfasst von: Anna C. Hearps, Genevieve E. Martin, Reena Rajasuriar, Suzanne M. Crowe

Erschienen in: Current HIV/AIDS Reports | Ausgabe 1/2014

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Abstract

Increased life expectancy due to improved efficacy of cART has uncovered an increased risk of age-related morbidities in HIV+ individuals and catalyzed significant research into mechanisms driving these diseases. HIV infection increases the risk of non-communicable diseases common in the aged, including cardiovascular disease, neurocognitive decline, non-AIDS malignancies, osteoporosis, and frailty. These observations suggest that HIV accelerates immunological ageing, and there are many immunological similarities with the aged, including shortened telomeres, accumulation of senescent T cells and altered monocyte phenotype/function. However, the most critical similarity between HIV+ individuals and the elderly, which most likely underpins the heightened risk of non-communicable diseases, is chronic inflammation and associated immune activation. Here, we review the similarities between HIV+ individuals and the aged regarding the pathogenesis of inflammatory diseases, the current evidence for mechanisms driving these processes and discuss current and potential therapeutic strategies for addressing inflammatory co-morbidity in HIV+ infection.

Deeks SG, Tracy R, Douek DC. Systemic Effects of Inflammation on Health during Chronic HIV Infection. Immunity. 2013;39:633–45.PubMed

Brenchley JM, Price DA, Schacker TW, et al. Microbial translocation is a cause of systemic immune activation in chronic HIV infection. Nat Med. 2006;12:1365–71.PubMed

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;26:843–53.PubMed

French MA, King MS, Tschampa JM, da Silva BA, Landay AL. Serum immune activation markers are persistently increased in patients with HIV infection after 6 years of antiretroviral therapy despite suppression of viral replication and reconstitution of CD4+ T cells. J Infect Dis. 2009;200:1212–5.PubMed

Burdo TH, Lentz MR, Autissier P, et al. Soluble CD163 made by monocyte/macrophages is a novel marker of HIV activity in early and chronic infection prior to and after anti-retroviral therapy. J Infect Dis. 2011;204:154–63.PubMed

Bazil V, Strominger JL. Shedding as a mechanism of down-modulation of CD14 on stimulated human monocytes. J Immunol. 1991;147:1567–74.PubMed

Murr C, Widner B, Wirleitner B, Fuchs D. Neopterin as a marker for immune system activation. Curr Drug Metab. 2002;3:175–87.PubMed

Neville LF, Mathiak G, Bagasra O. The immunobiology of interferon-gamma inducible protein 10 kD (IP-10): a novel, pleiotropic member of the C-X-C chemokine superfamily. Cytokine Growth Factor Rev. 1997;8:207–19.PubMed

Kowal K, Silver R, Slawinska E, et al. CD163 and its role in inflammation. Folia Histochem Cytobiol. 2011;49:365–74.PubMed

10.

Hart DN. Dendritic cells: unique leukocyte populations which control the primary immune response. Blood. 1997;90:3245–87.PubMed

11.

Lundahl J, Hallden G, Skold CM. Human blood monocytes, but not alveolar macrophages, reveal increased CD11b/CD18 expression and adhesion properties upon receptor-dependent activation. Eur Respir J. 1996;9:1188–94.PubMed

12.

Islam FM, Wu J, Jansson J, Wilson DP. Relative risk of cardiovascular disease among people living with HIV: a systematic review and meta-analysis. HIV Med. 2012;13:453–68.PubMed

13.

Friis-Moller N, Thiebaut R, Reiss P, et al. Predicting the risk of cardiovascular disease in HIV-infected patients: the data collection on adverse effects of anti-HIV drugs study. Eur J Cardiovasc Prev Rehabil. 2010;17:491–501.PubMed

14.

Triant VA, Lee H, Hadigan C, Grinspoon SK. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92:2506–12.PubMedCentralPubMed

15.

Sabin CA, Worm SW, Weber R, et al. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D:A:D study: a multi-cohort collaboration. Lancet. 2008;371:1417–26.PubMed

16.

group SIsgaDADs. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients. AIDS. 2008;22:F17–24.

17.

Worm SW, Sabin C, Weber R, et al. Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from the 3 major drug classes: the data collection on adverse events of anti-HIV drugs (D:A:D) study. J Infect Dis. 2010;201:318–30.PubMed

18.

Ribaudo HJ, Benson CA, Zheng Y, et al. No risk of myocardial infarction associated with initial antiretroviral treatment containing abacavir: short and long-term results from ACTG A5001/ALLRT. Clin Infect Dis. 2011;52:929–40.PubMed

19.

Ding X, Andraca-Carrera E, Cooper C, et al. No association of abacavir use with myocardial infarction: findings of an FDA meta-analysis. J Acquir Immune Defic Syndr. 2012;61:441–7.PubMed

20.

Danesh J, Kaptoge S, Mann AG, et al. Long-term interleukin-6 levels and subsequent risk of coronary heart disease: two new prospective studies and a systematic review. PLoS Med. 2008;5:e78.PubMedCentralPubMed

21.

Ridker PM. High-Sensitivity C-Reactive Protein: Potential Adjunct for Global Risk Assessment in the Primary Prevention of Cardiovascular Disease. Circulation. 2001;103:1813–8.PubMed

22.

Jenny NS, French B, Arnold AM, et al. Long-term assessment of inflammation and healthy aging in late life: the Cardiovascular Health Study All Stars. J Gerontol A Biol Sci Med Sci. 2012;67:970–6.PubMed

23.

El-Sadr WM, Lundgren J, Neaton JD, et al. CD4+ count-guided interruption of antiretroviral treatment. N Engl J Med. 2006;355:2283–96.PubMed

24.

Kuller LH, Tracy R, Belloso W, et al. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Med. 2008;5:e203.PubMedCentralPubMed

25.••

Duprez DA, Neuhaus J, Kuller LH, et al. Inflammation, coagulation and cardiovascular disease in HIV-infected individuals. PLoS One. 2012;7:e44454. This large-scale analysis of cardiovascular events in the SMART study demonstrated that the inflammatory markers IL-6, D-dimer and hsCRP confer an increased risk of cardiovascular events amongst treated, HIV infected individuals, independent of other risk factors. This important finding provides evidence for the role of inflammation in the development of non-AIDS comorbidities in HIV infected individuals. PubMedCentralPubMed

26.•

Subramanian S, Tawakol A, Burdo TH, et al. Arterial inflammation in patients with HIV. JAMA. 2012;308:379–86. This study demonstrates that HIV infected individuals have higher levels of arterial wall inflammation compared to controls matched for other cardiovascular risk factors, implicating inflammation as a plausible mechanism for the increased cardiovascular risk conferred by HIV infection. PubMedCentralPubMed

27.

Fernandez-Sender L, Alonso-Villaverde C, Rull A, et al. A possible role for CCR5 in the progression of atherosclerosis in HIV-infected patients: a cross-sectional study. AIDS Res Ther. 2013;10:11.PubMedCentralPubMed

28.

Cipriani S, Francisci D, Mencarelli A, et al. Efficacy of the CCR5 antagonist maraviroc in reducing early, ritonavir-induced atherogenesis and advanced plaque progression in mice. Circulation. 2013;127:2114–24.PubMed

29.

Wilkin TJ, Lalama CM, McKinnon J, et al. A pilot trial of adding maraviroc to suppressive antiretroviral therapy for suboptimal CD4(+) T-cell recovery despite sustained virologic suppression: ACTG A5256. J Infect Dis. 2012;206:534–42.PubMed

30.

Hunt PW, Shulman NS, Hayes TL, et al. The immunologic effects of maraviroc intensification in treated HIV-infected individuals with incomplete CD4+ T-cell recovery: a randomized trial. Blood. 2013;121:4635–46.PubMed

31.

Crowe SM, Westhorpe CL, Mukhamedova N, et al. The macrophage: the intersection between HIV infection and atherosclerosis. J Leukoc Biol. 2010;87:589–98.PubMed

32.

Fitch KV, Srinivasa S, Abbara S, et al. Noncalcified Coronary Atherosclerotic Plaque and Immune Activation in HIV-infected Women. J Infect Dis. 2013;208:1737–46.PubMed

33.

Funderburg NT, Zidar DA, Shive C, et al. Shared monocyte subset phenotypes in HIV-1 infection and in uninfected subjects with acute coronary syndrome. Blood. 2012;120:4599–608.PubMed

34.

Martin GE, Gouillou M, Hearps AC, et al. Age-associated changes in monocyte and innate immune activation markers occur more rapidly in HIV infected women. PLoS One. 2013;8:e55279.PubMedCentralPubMed

35.

Hearps AC, Martin GE, Angelovich TA, et al. Aging is associated with chronic innate immune activation and dysregulation of monocyte phenotype and function. Aging Cell. 2012;11:867–75.PubMed

36.

Nyugen J, Agrawal S, Gollapudi S, Gupta S. Impaired functions of peripheral blood monocyte subpopulations in aged humans. J Clin Immunol. 2010;30:806–13.PubMedCentralPubMed

37.

Seidler S, Zimmermann HW, Bartneck M, Trautwein C, Tacke F. Age-dependent alterations of monocyte subsets and monocyte-related chemokine pathways in healthy adults. BMC Immunol. 2010;11:30.PubMedCentralPubMed

38.

Rogacev KS, Cremers B, Zawada AM, et al. CD14++CD16+ Monocytes Independently Predict Cardiovascular Events: A Cohort Study of 951 Patients Referred for Elective Coronary Angiography. J Am Coll Cardiol. 2012;60:1512–20.PubMed

39.

Dopheide JF, Obst V, Doppler C, et al. Phenotypic characterisation of pro-inflammatory monocytes and dendritic cells in peripheral arterial disease. Thromb Haemost. 2012;108:1198–207.PubMed

40.

Burdo TH, Lo J, Abbara S, et al. Soluble CD163, a Novel Marker of Activated Macrophages, Is Elevated and Associated With Noncalcified Coronary Plaque in HIV-Infected Patients. J Infect Dis. 2011;204:1227–36.PubMed

41.

Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review. Aids. 2006;20:2165–74.PubMed

42.

Triant VA, Brown TT, Lee H, Grinspoon SK. Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system. J Clin Endocrinol Metab. 2008;93:3499–504.PubMed

43.

Torti C, Mazziotti G, Soldini PA, et al. High prevalence of radiological vertebral fractures in HIV-infected males. Endocrine. 2012;41:512–7.PubMed

44.

Yin MT, Zhang CA, McMahon DJ, et al. Higher rates of bone loss in postmenopausal HIV-infected women: a longitudinal study. J Clin Endocrinol Metab. 2012;97:554–62.PubMed

45.

Pinzone MR, Di Rosa M, Malaguarnera M, et al. Vitamin D deficiency in HIV infection: an underestimated and undertreated epidemic. Eur Rev Med Pharmacol Sci. 2013;17:1218–32.PubMed

46.

Ofotokun I, McIntosh E, Weitzmann MN. HIV: inflammation and bone. Curr HIV/AIDS Rep. 2012;9:16–25.PubMedCentralPubMed

47.

Zupan J, Jeras M, Marc J. Osteoimmunology and the influence of pro-inflammatory cytokines on osteoclasts. Biochem Med (Zagreb). 2013;23:43–63.

48.••

de Pablo P, Cooper MS, Buckley CD. Association between bone mineral density and C-reactive protein in a large population-based sample. Arthritis Rheum. 2012;64:2624–31. A large study investigating the realtionship between hs-CRP levels and BMD in a cohort of 10,475 individuals. hsCRP levels were significantly and inversely associated with BMD after adjustment for a range of demographic and lifestyle factors including age, poverty, menopause, body mass index, smoking, co-morbidities etc. The large particiant numbers and extensive adjustment for confounders provide strong evidence for a link between inflammation and reduecd BMD. PubMed

49.

Eriksson AL, Moverare-Skrtic S, Ljunggren O, et al.: High sensitive CRP is an independent risk factor for all fractures and vertebral fractures in elderly men: The MrOS Sweden study. J Bone Miner Res. 2013. doi:10.1002/jbmr.2037.

50.

Zou W, Bar-Shavit Z. Dual modulation of osteoclast differentiation by lipopolysaccharide. J Bone Miner Res. 2002;17:1211–8.PubMed

51.

Matuszewska A, Szechinski J. Evaluation of selected bone metabolism markers in rheumatoid arthritis patients. Adv Clin Exp Med. 2013;22:193–202.PubMed

52.

Ghishan FK, Kiela PR. Advances in the understanding of mineral and bone metabolism in inflammatory bowel diseases. Am J Physiol Gastrointest Liver Physiol. 2011;300:G191–201.PubMed

53.

Merlotti D, Gennari L, Dotta F, Lauro D, Nuti R. Mechanisms of impaired bone strength in type 1 and 2 diabetes. Nutr Metab Cardiovasc Dis. 2010;20:683–90.PubMed

54.

Lin JC, Hsieh TY, Wu CC, et al. Association between chronic hepatitis C virus infection and bone mineral density. Calcif Tissue Int. 2012;91:423–9.PubMed

55.

Vikulina T, Fan X, Yamaguchi M, et al. Alterations in the immuno-skeletal interface drive bone destruction in HIV-1 transgenic rats. Proc Natl Acad Sci U S A. 2010;107:13848–53.PubMedCentralPubMed

56.

Walker Harris V, Brown TT. Bone loss in the HIV-infected patient: evidence, clinical implications, and treatment strategies. J Infect Dis. 2012;205 Suppl 3:S391–8.PubMed

57.

Hoy J. Bone, fracture and frailty. Curr Opin HIV AIDS. 2011;6:309–14.PubMed

58.

Gazzola L, Bellistri GM, Tincati C, et al. Association between peripheral T-Lymphocyte activation and impaired bone mineral density in HIV-infected patients. J Transl Med. 2013;11:51.PubMedCentralPubMed

59.

Marchetti G, Tincati C, Silvestri G. Microbial Translocation in the Pathogenesis of HIV Infection and AIDS. Clin Microbiol Rev. 2013;26:2–18.PubMedCentralPubMed

60.

Sandler NG, Wand H, Roque A, et al. Plasma Levels of Soluble CD14 Independently Predict Mortality in HIV Infection. J Infect Dis. 2011;203:780–90.PubMed

61.

Rajasuriar R, Booth D, Solomon A, et al. Biological determinants of immune reconstitution in HIV-infected patients receiving antiretroviral therapy: the role of interleukin 7 and interleukin 7 receptor alpha and microbial translocation. J Infect Dis. 2010;202:1254–64.PubMed

62.

Jiang W, Lederman MM, Hunt P, et al. Plasma levels of bacterial DNA correlate with immune activation and the magnitude of immune restoration in persons with antiretroviral-treated HIV infection. J Infect Dis. 2009;199:1177–85.PubMedCentralPubMed

63.

Kitchens RL, Thompson PA. Modulatory effects of sCD14 and LBP on LPS-host cell interactions. J Endotoxin Res. 2005;11:225–9.PubMed

64.•

Reiner AP, Lange EM, Jenny NS, et al. Soluble CD14: Genomewide Association Analysis and Relationship to Cardiovascular Risk and Mortality in Older Adults. Arterioscler Thromb Vasc Biol. 2013;33:158–64. This study provides strong evidence for sCD14 as an independent predictor of cardiovascular events in previously healthy, aged individuals. The long-term follow up and large study size make this the strongest evidence linking sCD14 to cardiovascular disease in any population. PubMed

65.

Romero-Sanchez M, Gonzalez-Serna A, Pacheco YM, et al. Different biological significance of sCD14 and LPS in HIV-infection: importance of the immunovirology stage and association with HIV-disease progression markers. J Infect. 2012;65:431–8.PubMed

66.

Reus S, Portilla J, Sanchez-Paya J, et al. Low-level HIV viremia is associated with microbial translocation and inflammation. J Acquir Immune Defic Syndr. 2013;62:129–34.PubMed

67.

Méndez-Lagares G, Romero-Sánchez MC, Ruiz-Mateos E, et al. Long-term suppressive combined antiretroviral treatment does not normalize serum sCD14 levels. J Infect Dis. 2013;207(8):1221–5.PubMed

68.

Ancuta P, Kamat A, Kunstman KJ, et al. Microbial translocation is associated with increased monocyte activation and dementia in AIDS patients. PLoS One. 2008;3:e2516.PubMedCentralPubMed

69.

Kelesidis T, Kendall MA, Yang OO, Hodis HN, Currier JS. Biomarkers of microbial translocation and macrophage activation: association with progression of subclinical atherosclerosis in HIV-1 infection. J Infect Dis. 2012;206:1558–67.PubMed

70.

Marchetti G, Cozzi-Lepri A, Merlini E, et al. Microbial translocation predicts disease progression of HIV-infected antiretroviral-naive patients with high CD4+ cell count. Aids. 2011;25:1385–94.PubMed

71.

Blodget E, Shen C, Aldrovandi G, et al. Relationship between microbial translocation and endothelial function in HIV infected patients. PLoS ONE. 2012;7:e42624. Electronic Resource.PubMedCentralPubMed

72.

Pedersen KK, Pedersen M, Troseid M, et al. Microbial Translocation in HIV Infection is Associated with Dyslipidemia, Insulin Resistance, and Risk of Myocardial Infarction. J Acquir Immune Defic Syndr. 2013;64:425–33.PubMed

73.

Manner IW, Baekken M, Kvale D, et al. Markers of microbial translocation predict hypertension in HIV-infected individuals. HIV Med. 2013;14:354–61.PubMed

74.

Balagopal A, Gama L, Franco V, et al. Detection of microbial translocation in HIV and SIV infection using the Limulus amebocyte lysate assay is masked by serum and plasma. PLoS ONE. 2012;7:e41258. Electronic Resource.PubMedCentralPubMed

75.

Hurley JC. Endotoxemia: methods of detection and clinical correlates. Clin Microbiol Rev. 1995;8:268–92.PubMedCentralPubMed

76.

Nilsson PM, Tufvesson H, Leosdottir M, and Melander O: Telomeres and cardiovascular disease risk: an update 2013. Transl Res. 2013;162:371–80.

77.

Kong CM, Lee XW, Wang X. Telomere shortening in human diseases. FEBS J. 2013;280:3180–93.PubMed

78.

Weischer M, Bojesen SE, Cawthon RM, et al. Short telomere length, myocardial infarction, ischemic heart disease, and early death. Arterioscler Thromb Vasc Biol. 2012;32:822–9.PubMed

79.

Willeit P, Willeit J, Brandstatter A, et al. Cellular aging reflected by leukocyte telomere length predicts advanced atherosclerosis and cardiovascular disease risk. Arterioscler Thromb Vasc Biol. 2010;30:1649–56.PubMed

80.

Sanders JL, Fitzpatrick AL, Boudreau RM, et al. Leukocyte telomere length is associated with noninvasively measured age-related disease: The Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2012;67:409–16.PubMed

81.

Fitzpatrick AL, Kronmal RA, Gardner JP, et al. Leukocyte telomere length and cardiovascular disease in the cardiovascular health study. Am J Epidemiol. 2007;165:14–21.PubMed

82.

Effros RB, Allsopp R, Chiu CP, et al.: Shortened telomeres in the expanded CD28-CD8+ cell subset in HIV disease implicate replicative senescence in HIV pathogenesis. AIDS. 1996;10:F17–22.

83.

Effros RB, Dagarag M, Spaulding C, Man J. The role of CD8+ T-cell replicative senescence in human aging. Immunol Rev. 2005;205:147–57.PubMed

84.

Ballon G, Ometto L, Righetti E, et al. Human immunodeficiency virus type 1 modulates telomerase activity in peripheral blood lymphocytes. J Infect Dis. 2001;183:417–24.PubMed

85.

Reynoso R, Laufer N, Bolcic F, Quarleri J. Telomerase activity in peripheral blood mononuclear cells from HIV and HIV-HCV coinfected patients. Virus Res. 2010;147:284–7.PubMed

86.

Leeansyah E, Cameron PU, Solomon A, et al. Inhibition of telomerase activity by human immunodeficiency virus (HIV) nucleos(t)ide reverse transcriptase inhibitors: a potential factor contributing to HIV-associated accelerated aging. J Infect Dis. 2013;207:1157–65.PubMed

87.

Bollmann FM. Telomerase inhibition may contribute to accelerated mitochondrial aging induced by anti-retroviral HIV treatment. Med Hypotheses. 2013;81:285–7.PubMed

88.

Comandini A, Naro C, Adamo R, et al. Molecular mechanisms involved in HIV-1-Tat mediated inhibition of telomerase activity in human CD4(+) T lymphocytes. Mol Immunol. 2013;54:181–92.PubMed

89.

Wang X, Singh S, Jung HY, et al. HIV-1 Vpr protein inhibits telomerase activity via the EDD-DDB1-VPRBP E3 ligase complex. J Biol Chem. 2013;288:15474–80.PubMed

90.

Di Mitri D, Azevedo RI, Henson SM, et al. Reversible senescence in human CD4 + CD45RA + CD27- memory T cells. J Immunol. 2011;187:2093–100.PubMed

91.

Parish ST, Wu JE, Effros RB. Modulation of T lymphocyte replicative senescence via TNF-{alpha} inhibition: role of caspase-3. J Immunol. 2009;182:4237–43.PubMedCentralPubMed

92.

Ouyang Q, Wagner WM, Wikby A, et al. Large numbers of dysfunctional CD8+ T lymphocytes bearing receptors for a single dominant CMV epitope in the very old. J Clin Immunol. 2003;23:247–57.PubMed

93.••

Derhovanessian E, Maier AB, Hahnel K, et al. Infection with cytomegalovirus but not herpes simplex virus induces the accumulation of late-differentiated CD4+ and CD8+ T-cells in humans. J Gen Virol. 2011;92:2746–56. This analysis of the effect of CMV and herpes simplex virus on T cell subsets in the aged demostrated that the expansion of CD28- memory T cells and ‘senescent’ CD57+ CD8+ T cells previously thought to be due to ageing is only seen in CMV seropositive individuals. This highlights the important roel CMV plays in immunosenescence and the need to adjust for CMV status, and ideally CMV reactivation, in studies of immune activation and ageing. PubMed

94.

Chidrawar S, Khan N, Wei W, et al. Cytomegalovirus-seropositivity has a profound influence on the magnitude of major lymphoid subsets within healthy individuals. Clin Exp Immunol. 2009;155:423–32.PubMedCentralPubMed

95.

Solana R, Tarazona R, Aiello AE, et al. CMV and Immunosenescence: from basics to clinics. Immun Ageing. 2012;9:23.PubMedCentralPubMed

96.

Simanek AM, Dowd JB, Pawelec G, et al. Seropositivity to cytomegalovirus, inflammation, all-cause and cardiovascular disease-related mortality in the United States. PLoS ONE. 2011;6:e16103.PubMedCentralPubMed

97.

Muhlestein JB, Horne BD, Carlquist JF, et al. Cytomegalovirus seropositivity and C-reactive protein have independent and combined predictive value for mortality in patients with angiographically demonstrated coronary artery disease. Circulation. 2000;102:1917–23.PubMed

98.

Naeger DM, Martin JN, Sinclair E, et al. Cytomegalovirus-specific T cells persist at very high levels during long-term antiretroviral treatment of HIV disease. PLoS One. 2010;5:e8886.PubMedCentralPubMed

99.

Gianella S, Morris SR, Tatro E, et al.: Virologic Correlates of Anti-CMV IgG Levels in HIV-1 Infected Men. J Infect Dis. 2013. doi:10.1093/infdis/jit434.

100.

Parrinello CM, Sinclair E, Landay AL, et al. Cytomegalovirus immunoglobulin G antibody is associated with subclinical carotid artery disease among HIV-infected women. J Infect Dis. 2012;205:1788–96.PubMed

101.

Hsue PY, Hunt PW, Sinclair E, et al. Increased carotid intima-media thickness in HIV patients is associated with increased cytomegalovirus-specific T-cell responses. AIDS. 2006;20:2275–83.PubMed

102.

Durier N, Ananworanich J, Apornpong T, et al. Cytomegalovirus viremia in Thai HIV-infected patients on antiretroviral therapy: prevalence and associated mortality. Clin Infect Dis. 2013;57:147–55.PubMed

103.

Hunt PW, Martin JN, Sinclair E, et al. Valganciclovir reduces T cell activation in HIV-infected individuals with incomplete CD4+ T cell recovery on antiretroviral therapy. J Infect Dis. 2011;203:1474–83.PubMed

104.

van Baarle D, Tsegaye A, Miedema F, Akbar A. Significance of senescence for virus-specific memory T cell responses: rapid ageing during chronic stimulation of the immune system. Immunol Lett. 2005;97:19–29.PubMed

105.

Davalos AR, Coppe JP, Campisi J, Desprez PY. Senescent cells as a source of inflammatory factors for tumor progression. Cancer Metastasis Rev. 2010;29:273–83.PubMedCentralPubMed

106.

Deeks SG, Verdin E, McCune JM. Immunosenescence and HIV. Curr Opin Immunol. 2012;24:501–6.PubMed

107.

Kaplan RC, Sinclair E, Landay AL, et al. T cell activation and senescence predict subclinical carotid artery disease in HIV-infected women. J Infect Dis. 2011;203:452–63.PubMed

108.

Kaplan RC, Sinclair E, Landay AL, et al. T cell activation predicts carotid artery stiffness among HIV-infected women. Atherosclerosis. 2011;217:207–13.PubMedCentralPubMed

109.

Tincati C, Bellistri GM, Casana M, et al. CD8+ hyperactivation and senescence correlate with early carotid intima-media thickness in HIV+ patients with no cardiovascular disease. J Acquir Immune Defic Syndr. 2009;51:642–4.PubMed

110.

Ford ES, Greenwald JH, Richterman AG, et al. Traditional risk factors and D-dimer predict incident cardiovascular disease events in chronic HIV infection. AIDS. 2010;24:1509–17.PubMedCentralPubMed

111.

Baker J, Huppler Hullsiek K, and Singh A, Monocyte Activation, but Not T Cell Activation, Predicts Progression of Coronary Artery Calcium in a Contemporary HIV Cohort (Abstract 66LB), in 20th Conference on Retroviruses and Opportunistic Infections 2013: Atlanta, GA, USA.

112.

Tenorio A, Zheng E, and Bosch R, Soluble Markers of Inflammation and Coagulation, but Not T Cell Activation, Predict Non-AIDS-defining Events during Suppressive ART (Abstract 790), in 20th Conference on Retroviruses and Opportunistic Infections2013: Atlanta, GA, USA.

113.

Unemori P, Leslie KS, Hunt PW, et al. Immunosenescence is associated with presence of Kaposi's sarcoma in antiretroviral treated HIV infection. AIDS. 2013;27:1735–42.PubMed

114.

Lichtenstein K, Armon C, Buchacz K, et al. Low CD4+ T Cell Count Is a Risk Factor for Cardiovascular Disease Events in the HIV Outpatient Study. Clin Infect Dis. 2010;51:435–47.PubMed

115.

Prosperi MC, Cozzi-Lepri A, Castagna A, et al. Incidence of malignancies in HIV-infected patients and prognostic role of current CD4 cell count: evidence from a large Italian cohort study. Clin Infect Dis. 2010;50:1316–21.PubMed

116.

Onen NF, Agbebi A, Shacham E, et al. Frailty among HIV-infected persons in an urban outpatient care setting. J Infect. 2009;59:346–52.PubMed

117.

Pathai S, Gilbert C, Weiss HA, et al. Frailty in HIV-infected adults in South Africa. J Acquir Immune Defic Syndr. 2013;62:43–51.PubMedCentralPubMed

118.

Yong MK, Elliott JH, Woolley IJ, Hoy JF. Low CD4 count is associated with an increased risk of fragility fracture in HIV-infected patients. J Acquir Immune Defic Syndr. 2011;57:205–10.PubMed

119.

Guaraldi G, Orlando G, Zona S, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53:1120–6.PubMed

120.

Hasse B, Ledergerber B, Furrer H, et al. Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis. 2011;53:1130–9.PubMed

121.

Galli L, Salpietro S, Pellicciotta G, et al. Risk of type 2 diabetes among HIV-infected and healthy subjects in Italy. Eur J Epidemiol. 2012;27:657–65.PubMed

122.

Malaza A, Mossong J, Barnighausen T, Newell ML. Hypertension and obesity in adults living in a high HIV prevalence rural area in South Africa. PLoS ONE. 2012;7:e47761.PubMedCentralPubMed

123.

Wand H, Ramjee G. High prevalence of obesity among women who enrolled in HIV prevention trials in KwaZulu-Natal, South Africa: healthy diet and life style messages should be integrated into HIV prevention programs. BMC Public Health. 2013;13:159.PubMedCentralPubMed

124.

Ramachandran A, Snehalatha C. Rising burden of obesity in Asia. J Obes. 2010(2010).

125.

Tian S, Dong GH, Wang D, et al. Factors associated with prevalence, awareness, treatment and control of hypertension in urban adults from 33 communities in China: the CHPSNE Study. Hypertens Res. 2011;34:1087–92.PubMed

126.

Kengne AP, Echouffo-Tcheugui JB, Sobngwi E, Mbanya JC. New insights on diabetes mellitus and obesity in Africa-part 1: prevalence, pathogenesis and comorbidities. Heart. 2013;99:979–83.PubMed

127.

Hunter DJ, Reddy KS. Noncommunicable diseases. N Engl J Med. 2013;369:1336–43.PubMed

128.

Tang S, Ehiri J, Long Q. China's biggest, most neglected health challenge: Non-communicable diseases. Infect Dis Poverty. 2013;2:7.PubMedCentralPubMed

129.

Hamill MM, Ward KA, Pettifor JM, Norris SA, and Prentice A: Bone mass, body composition and vitamin D status of ARV-naive, urban, black South African women with HIV infection, stratified by CD count. Osteoporos Int. 2013;24:2855–61.

130.

Muronya W, Sanga E, Talama G, Kumwenda JJ, van Oosterhout JJ. Cardiovascular risk factors in adult Malawians on long-term antiretroviral therapy. Trans R Soc Trop Med Hyg. 2011;105:644–9.PubMed

131.

Mateen FJ, Kanters S, Kalyesubula R, et al. Hypertension prevalence and Framingham risk score stratification in a large HIV-positive cohort in Uganda. J Hypertens. 2013;31:1372–8. discussion 1378.PubMed

132.

Bloomfield GS, Hogan JW, Keter A, et al. Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya. PLoS ONE. 2011;6:e22288.PubMedCentralPubMed

133.

Tsai MS, Hung CC, Liu WC, et al. Reduced bone mineral density among HIV-infected patients in Taiwan: prevalence and associated factors. J Microbiol Immunol Infect. 2012. doi:10.1016/j.jmii.2012.08.026.

134.

Erlandson KM, Allshouse AA, Jankowski CM, et al. Association of functional impairment with inflammation and immune activation in HIV type 1-infected adults receiving effective antiretroviral therapy. J Infect Dis. 2013;208:249–59.PubMed

135.

Appay V, Fastenackels S, Katlama C, et al. Old age and anti-cytomegalovirus immunity are associated with altered T-cell reconstitution in HIV-1-infected patients. AIDS. 2011;25:1813–22.PubMed

136.

Masia M, Robledano C. Ortiz de la Tabla V, et al.: Increased carotid intima-media thickness associated with antibody responses to varicella-zoster virus and cytomegalovirus in HIV-infected patients. PLoS ONE. 2013;8:e64327.PubMedCentralPubMed

137.

Cassol E, Malfeld S, Mahasha P, et al. Persistent microbial translocation and immune activation in HIV-1-infected South Africans receiving combination antiretroviral therapy. J Infect Dis. 2010;202:723–33.PubMed

138.

Ledwaba L, Tavel JA, Khabo P, et al. Pre-ART levels of inflammation and coagulation markers are strong predictors of death in a South African cohort with advanced HIV disease. PLoS ONE. 2012;7:e24243.PubMedCentralPubMed

139.

Ford N, Shubber Z, Saranchuk P, et al.: Burden of HIV-Related Cytomegalovirus Retinitis in Resource-Limited Settings: A Systematic Review. Clin Infect Dis. 2013;57:1351–61.

140.

Nakanjako D, Ssewanyana I, Nabatanzi R, et al. Impaired T-cell proliferation among HAART-treated adults with suboptimal CD4 recovery in an African cohort. BMC Immunol. 2013;14:26.PubMedCentralPubMed

141.

Hunt PW, Cao HL, Muzoora C, et al. Impact of CD8+ T-cell activation on CD4+ T-cell recovery and mortality in HIV-infected Ugandans initiating antiretroviral therapy. AIDS. 2011;25:2123–31.PubMedCentralPubMed

142.

Shiels PG, McGlynn LM, MacIntyre A, et al. Accelerated telomere attrition is associated with relative household income, diet and inflammation in the pSoBid cohort. PLoS ONE. 2011;6:e22521.PubMedCentralPubMed

143.

Atun R, Jaffar S, Nishtar S, et al. Improving responsiveness of health systems to non-communicable diseases. Lancet. 2013;381:690–7.PubMed

144.

Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. 2013;382:1525–33.PubMed

145.

Nelson MR, Reid CM, Ames DA, et al. Feasibility of conducting a primary prevention trial of low-dose aspirin for major adverse cardiovascular events in older people in Australia: results from the ASPirin in Reducing Events in the Elderly (ASPREE) pilot study. Med J Aust. 2008;189:105–9.PubMed

146.•

O'Brien M, Montenont E, Hu L, et al. Aspirin attenuates platelet activation and immune activation in HIV-infected subjects on antiretroviral therapy: A Pilot Study. J Acquir Immune Defic Syndr. 2013;63:280–8. Reporting the striking finding of significantly reduced T cell actiavtion and sCD14 levels in virologically suppressed HIV+ individuals after only 1 week of treatment with aspirin. Although only a small study (25 HIV+ and 45 control participants), the data highlight the significant activation of platlets in HIV infection and the influence this has on monocyte activation and thus inflammation/immune activation. This is to date a poorly investigated area in HIV infection. PubMed

147.

Antonopoulos AS, Margaritis M, Lee R, Channon K, Antoniades C. Statins as anti-inflammatory agents in atherogenesis: molecular mechanisms and lessons from the recent clinical trials. Curr Pharm Des. 2012;18:1519–30.PubMedCentralPubMed

148.

Calza L, Trapani F, Bartoletti M, et al. Statin Therapy Decreases Serum Levels of High-Sensitivity C-Reactive Protein and Tumor Necrosis Factor-α in HIV-Infected Patients Treated With Ritonavir-Boosted Protease Inhibitors. HIV Clinical Trials. 2012;13:153–61.PubMed

149.

Baker JV, Huppler Hullsiek K, Prosser R, et al. Angiotensin Converting Enzyme Inhibitor and HMG-CoA Reductase Inhibitor as Adjunct Treatment for Persons with HIV Infection: A Feasibility Randomized Trial. PLoS ONE. 2012;7:e46894.PubMedCentralPubMed

150.

De Wit S, Delforge M, Necsoi CV, Clumeck N. Downregulation of CD38 activation markers by atorvastatin in HIV patients with undetectable viral load. Aids. 2011;25:1332–3.PubMed

151.

Fichtenbaum CJ, Yeh TM, Evans SR, Aberg JA. Treatment with pravastatin and fenofibrate improves atherogenic lipid profiles but not inflammatory markers in ACTG 5087. J Clin Lipidol. 2010;4:279–87.PubMedCentralPubMed

152.

Rasmussen LD, Kronborg G, Larsen CS, et al. Statin Therapy and Mortality in HIV-Infected Individuals; A Danish Nationwide Population-Based Cohort Study. PLoS ONE. 2013;8:e52828.PubMedCentralPubMed

153.

Piconi S, Parisotto S, Rizzardini G, et al. Hydroxychloroquine drastically reduces immune activation in HIV-infected, antiretroviral therapy–treated immunologic nonresponders. Blood. 2011;118:3263–72.PubMed

154.

Murray SM, Down CM, Boulware DR, et al. Reduction of immune activation with chloroquine therapy during chronic HIV infection. J Virol. 2010;84:12082–6.PubMedCentralPubMed

155.

Paton Ni GRLDDT et al. Effects of hydroxychloroquine on immune activation and disease progression among hiv-infected patients not receiving antiretroviral therapy: A randomized controlled trial. JAMA. 2012;308:353–61.PubMed

156.

Cunningham-Rundles S, Ahrne S, Johann-Liang R, et al. Effect of probiotic bacteria on microbial host defense, growth, and immune function in human immunodeficiency virus type-1 infection. Nutrients. 2011;3:1042–70.PubMedCentralPubMed

157.

Klatt NR, Canary LA, Sun X, et al. Probiotic/prebiotic supplementation of antiretrovirals improves gastrointestinal immunity in SIV-infected macaques. J Clin Invest. 2013;123:903–7.PubMedCentralPubMed

158.

Gonzalez-Hernandez LA, Jave-Suarez LF, Fafutis-Morris M, et al. Synbiotic therapy decreases microbial translocation and inflammation and improves immunological status in HIV-infected patients: a double-blind randomized controlled pilot trial. Nutr J. 2012;11:90.PubMedCentralPubMed

159.

Schunter M, Chu H, Hayes TL, et al. Randomized pilot trial of a synbiotic dietary supplement in chronic HIV-1 infection. BMC Complement Alternat Med. 2012;12:84.

160.

Lassenius MI, Pietilainen KH, Kaartinen K, et al. Bacterial endotoxin activity in human serum is associated with dyslipidemia, insulin resistance, obesity, and chronic inflammation. Diabetes Care. 2011;34:1809–15.PubMed

161.

Gonzalez-Quintela A, Alonso M, Campos J, et al. Determinants of serum concentrations of lipopolysaccharide-binding protein (LBP) in the adult population: the role of obesity. PLoS One. 2013;8:e54600.PubMedCentralPubMed

162.

De Luca A, de Gaetano DK, Colafigli M, et al. The association of high-sensitivity c-reactive protein and other biomarkers with cardiovascular disease in patients treated for HIV: a nested case–control study. BMC Infect Dis. 2013;13:414.PubMedCentralPubMed

163.

Koethe JR, Dee K, Bian A, et al. Circulating interleukin-6, soluble CD14, and other inflammation biomarker levels differ between obese and nonobese HIV-infected adults on antiretroviral therapy. AIDS Res Hum Retrovir. 2013;29:1019–25.PubMed

164.

Hussein AA, Gottdiener JS, Bartz TM, et al. Inflammation and sudden cardiac death in a community-based population of older adults: The Cardiovascular Health Study. Heart Rhythm. 2013;10:1425–32.PubMed

165.

Empana JP, Jouven X, Canoui-Poitrine F, et al. C-reactive protein, interleukin 6, fibrinogen and risk of sudden death in European middle-aged men: the PRIME study. Arterioscler Thromb Vasc Biol. 2010;30:2047–52.PubMed

166.

Ridker PM, Rifai N, Stampfer MJ, Hennekens CH. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation. 2000;101:1767–72.PubMed

167.

Jenny NS, Tracy RP, Ogg MS, et al. In the elderly, interleukin-6 plasma levels and the -174G > C polymorphism are associated with the development of cardiovascular disease. Arterioscler Thromb Vasc Biol. 2002;22:2066–71.PubMed

168.

Hsue PY, Scherzer R, Hunt PW, et al.: Carotid Intima-Media Thickness Progression in HIV-Infected Adults Occurs Preferentially at the Carotid Bifurcation and Is Predicted by Inflammation. Journal of the American Heart Association. 2012, 1. doi:10.1161/JAHA.111.000422.

169.

Biron A, Bobin-Dubigeon C, Volteau C, et al. Metabolic syndrome in French HIV-infected patients: prevalence and predictive factors after 3 years of antiretroviral therapy. AIDS Res Hum Retrovir. 2012;28:1672–8.PubMed

170.

Brown TT, Tassiopoulos K, Bosch RJ, Shikuma C, McComsey GA. Association between systemic inflammation and incident diabetes in HIV-infected patients after initiation of antiretroviral therapy. Diabetes Care. 2010;33:2244–9.PubMed

171.

Schnabel RB, Yin X, Larson MG, et al. Multiple inflammatory biomarkers in relation to cardiovascular events and mortality in the community. Arterioscler Thromb Vasc Biol. 2013;33:1728–33.PubMed

172.

Parkner T, Sorensen LP, Nielsen AR, et al. Soluble CD163: a biomarker linking macrophages and insulin resistance. Diabetologia. 2012;55:1856–62.PubMed

173.

Hileman CO, Longenecker CT, Carman TL, et al. Elevated D-dimer is independently associated with endothelial dysfunction: a cross-sectional study in HIV-infected adults on antiretroviral therapy. Antivir Ther. 2012;17:1345–9.PubMed

174.

Longenecker C, Funderburg N, Jiang Y, et al.: Markers of inflammation and CD8 T-cell activation, but not monocyte activation, are associated with subclinical carotid artery disease in HIV-infected individuals. HIV Med. 2013;14:385–90.

175.

Merlini E, Luzi K, Suardi E, et al. T-cell phenotypes, apoptosis and inflammation in HIV+ patients on virologically effective cART with early atherosclerosis. PLoS One. 2012;7:e46073.PubMedCentralPubMed

176.

Shikuma CM, Barbour JD, Ndhlovu LC, et al.: Plasma Monocyte Chemoattractant Protein-1 and Tumor Necrosis Factor-alpha Levels Predict the Presence of Coronary Artery Calcium in HIV-Infected Individuals Independent of Traditional Cardiovascular Risk Factors. AIDS Res Hum Retroviruses. 2013. doi:10.1089/aid.2013.0183.

177.

Aristoteli LP, Moller HJ, Bailey B, Moestrup SK, Kritharides L. The monocytic lineage specific soluble CD163 is a plasma marker of coronary atherosclerosis. Atherosclerosis. 2006;184:342–7.PubMed

178.

Fjeldborg K, Christiansen T, Bennetzen M, et al. The Macrophage-Specific Serum Marker, Soluble CD163, Is Increased in Obesity and Reduced After Dietary-Induced Weight Loss. Obesity. 2013. doi:10.1002/oby.20376. Silver Spring.PubMed

179.

Zanni MV, Burdo TH. Makimura H, Williams KC, and Grinspoon SK: Relationship between monocyte/macrophage activation marker soluble CD163 and insulin resistance in obese and normal-weight subjects. Clin Endocrinol (Oxf). 2012;77:385–90.

180.

Moller HJ, Frikke-Schmidt R, Moestrup SK, Nordestgaard BG, Tybjaerg-Hansen A. Serum soluble CD163 predicts risk of type 2 diabetes in the general population. Clin Chem. 2011;57:291–7.PubMed

181.

Vassallo M, Dunais B, Durant J, et al. Relevance of lipopolysaccharide levels in HIV-associated neurocognitive impairment: the Neuradapt study. J Neurovirol. 2013;19:376–82.PubMed

182.

Weaver JD, Huang MH, Albert M, et al. Interleukin-6 and risk of cognitive decline: MacArthur studies of successful aging. Neurology. 2002;59:371–8.PubMed

183.

Noble JM, Manly JJ, Schupf N, et al. Association of C-reactive protein with cognitive impairment. Arch Neurol. 2010;67:87–92.PubMed

184.

Ryan LA, Zheng J, Brester M, et al. Plasma levels of soluble CD14 and tumor necrosis factor-alpha type II receptor correlate with cognitive dysfunction during human immunodeficiency virus type 1 infection. J Infect Dis. 2001;184:699–706.PubMed

185.

Kamat A, Lyons JL, Misra V, et al.: Monocyte Activation Markers in Cerebrospinal Fluid Associated With Impaired Neurocognitive Testing in Advanced HIV Infection. J Acquir Immune Defic Syndr 2012, 60:234–243 10.

186.

Lyons JL, Uno H, Ancuta P, et al.: Plasma sCD14 Is a Biomarker Associated With Impaired Neurocognitive Test Performance in Attention and Learning Domains in HIV Infection. J Acquir Immune Defic Syndr 2011, 57:371–379 10.

187.

Engelhart MJ, Geerlings MI, Meijer J, et al. Inflammatory proteins in plasma and the risk of dementia: the rotterdam study. Arch Neurol. 2004;61:668–72.PubMed

188.

Bruunsgaard H, Andersen-Ranberg K, Jeune B, et al. A high plasma concentration of TNF-alpha is associated with dementia in centenarians. J Gerontol A Biol Sci Med Sci. 1999;54:M357–64.PubMed

189.

Burdo TH, Weiffenbach A, Woods SP, et al. Elevated sCD163 in plasma but not cerebrospinal fluid is a marker of neurocognitive impairment in HIV infection. Aids. 2013;27:1387–95.PubMed

190.

Blasko I, Knaus G, Weiss E, et al. Cognitive deterioration in Alzheimer's disease is accompanied by increase of plasma neopterin. J Psychiatr Res. 2007;41:694–701.PubMed

191.

Marks MA, Rabkin CS, Engels EA, et al. Markers of microbial translocation and risk of AIDS-related lymphoma. AIDS. 2013;27:469–74.PubMed

192.

Borges AH, Silverberg MJ, Wentworth D, et al. Predicting risk of cancer during HIV infection: the role of inflammatory and coagulation biomarkers. Aids. 2013;27:1433–41.PubMed

193.

Il'yasova D, Colbert LH, Harris TB, et al. Circulating levels of inflammatory markers and cancer risk in the health aging and body composition cohort. Cancer Epidemiol Biomarkers Prev. 2005;14:2413–8.PubMed

194.

Ding C, Parameswaran V, Udayan R, Burgess J, Jones G. Circulating levels of inflammatory markers predict change in bone mineral density and resorption in older adults: a longitudinal study. J Clin Endocrinol Metab. 2008;93:1952–8.PubMed

195.

Scheidt-Nave C, Bismar H, Leidig-Bruckner G, et al. Serum interleukin 6 is a major predictor of bone loss in women specific to the first decade past menopause. J Clin Endocrinol Metab. 2001;86:2032–42.PubMed

196.

Margolick J, Jacobson L, and Lopez J, Frailty and circulating concentrations of proinflammatory cytokines and chemokines in HIV-infected and -uninfected men in the Multicenter AIDS Cohort Study (MACS). , in 3rd International Workshop on HIV and Aging. 2012: Baltimore, USA.

197.

Ferrucci L, Harris TB, Guralnik JM, et al. Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc. 1999;47:639–46.PubMed

198.

Walston J, McBurnie MA, Newman A, et al. Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study. Arch Intern Med. 2002;162:2333–41.PubMed

199.

Leng SX, Tian X, Matteini A, et al. IL-6-independent association of elevated serum neopterin levels with prevalent frailty in community-dwelling older adults. Age Ageing. 2011;40:475–81.PubMed

Titel: Inflammatory Co-morbidities in HIV+ Individuals: Learning Lessons from Healthy Ageing
verfasst von: Anna C. Hearps
Genevieve E. Martin
Reena Rajasuriar
Suzanne M. Crowe
Publikationsdatum: 01.03.2014
Verlag: Springer US
Erschienen in: Current HIV/AIDS Reports / Ausgabe 1/2014
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI: https://doi.org/10.1007/s11904-013-0190-8

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