Objectives: Despite successful antiretroviral therapy, people living with HIV (PLWH)
may show signs of premature/accentuated aging. We compared established biomarkers
of aging in PLWH, appropriately chosen HIV-negative individuals, and blood donors,
and explored factors associated with biological age advancement.
Design: Cross-sectional analysis of 134 PLWH on suppressive antiretroviral therapy, 79
lifestyle-comparable HIV-negative controls aged 45 years or older from the Co-morBidity in Relation to AIDS (COBRA) cohort, and 35 age-matched blood donors.
Methods: Biological age was estimated using a validated algorithm based on 10
biomarkers. Associations between ‘age advancement’ (biological minus chronological age) and HIV status/parameters, lifestyle, cytomegalovirus (CMV), hepatitis
B (HBV) and hepatitis C virus (HCV) infections were investigated using linear regression.
Results: The average (95% CI) age advancement was greater in both HIV-positive [13.2
(11.6–14.9) years] and HIV-negative [5.5 (3.8–7.2) years] COBRA participants compared
with blood donors [7.0 (4.1 to 9.9) years, both P’s< 0.001)], but also in HIV-positive
compared with HIV-negative participants (P < 0.001). Chronic HBV, higher anti-CMV
IgG titer and CD8þ T-cell count were each associated with increased age advancement, independently of HIV-status/group. Among HIV-positive participants, age
advancement was increased by 3.5 (0.1–6.8) years among those with nadir CD4þ
T-cell count less than 200 cells/ml and by 0.1 (0.06–0.2) years for each additional
month of exposure to saquinavir.