Ageing and inflammation in patients with HIV infection

HIV+ patients have nowadays an expected life span that is only slightly shorter than healthy individuals. For this reason, along with the fact that infection can be acquired in a relatively advanced age, the effects of aging on HIV+ persons have begun to be evident. Successful antiviral treatment is, on the one side, responsible for the development of side effects related to drug toxicity, on the other is not able to inhibit the onset of several complications caused by persistent immune activation and chronic inflammation. Then, patients with a relatively advanced age, i.e., over 50 years old, can experience pathologies that affect much older citizens. HIV+ individuals with non-AIDS related complications can thus arrive to the attention of clinicians because of the presence of neurocognitive disorders, cardiovascular diseases, metabolic syndrome, bone abnormalities, and non-HIV associated cancers. Chronic inflammation and immune activation that are typically observed in elderly people and were defined “inflammaging” can be present in HIV+ patients, who experience a sort of premature aging, which affects heavily the quality of life. This relatively new condition is very complex, and important factors have been identified beside the traditional behavioral risk factors, that are the toxicity of antiretroviral treatments and the above-mentioned chronic inflammation leading to a functional decline and a vulnerability to injury or pathologies. Here, we discuss the role of inflammation and immune activation on the most important non-AIDS related complications of chronic HIV infection, and the contribution of aging per se to this scenario. This article is protected by copyright. All rights reserved.