{"id":42052,"date":"2022-02-07T07:23:55","date_gmt":"2022-02-07T07:23:55","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=42052"},"modified":"2022-10-13T15:20:27","modified_gmt":"2022-10-13T15:20:27","slug":"effective-art-prevents-hiv-associated-reductions-in-telomere-length","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/42052","title":{"rendered":"HIV-associated reductions in telomere length are stopped by effective ART"},"content":{"rendered":"
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Simon Collins, HIV i-Base<\/strong><\/p>\n<\/div>\n

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Results from a 17-year study report that untreated HIV is associated with significant reductions in telemere length (TL) but that effective ART stopped further damage. [1]<\/span><\/strong><\/p>\n<\/div>\n

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TL is associated with ageing, coronary artery disease (CAD) and all-cause mortality in the general population. In people living with HIV, TL has also been associated with metabolic syndrome, neurocognitive impairment and concerns about accelerated or accentuated ageing.<\/span><\/p>\n<\/div>\n

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This was a longitudinal analysis from the Swiss HIV Cohort Study where 107 participants were followed for a minimum of three years before starting ART (median 7.7 years; IQR: 4.7 to 11) and for a minimum of three years after (median 9.8 years; IQR: 7.1 to 11.1).<\/span><\/p>\n<\/div>\n

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Change in TL was measured in PBMCs by quantitative PCR and the analysis adjusted age, sex and CD4:CD8 ratio. <\/span><\/p>\n<\/div>\n

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In the years before ART, TL significantly dropped by a median \u22122.12% per year (IQR, \u22123.48% to \u22120.76%), p=0.002. This compared to no significant changes when on suppressive ART: median change + 0.54% per year (IQR, \u22120.55% to + 1.63%) p=0.329.<\/span><\/p>\n<\/div>\n

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No association was found between changes in TL and individual HIV drugs. However, an individual TL risk score based on 239 single-nucleotide polymorphisms identified in the group’s previous work did continue to correlate with reductions (global p=0.019).<\/span><\/p>\n<\/div>\n

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comment<\/span><\/h3>\n

This impressive dataset reports both an under-appreciated concern of untreated ART and a benefit from suppressive ART that is large enough to likely have clinical significance. <\/span><\/strong><\/p>\n

It further supports the importance of universal ART on long-term health.<\/span><\/strong><\/p>\n

A poster just presented at CROI 2022 from the CHARTER study reported that TAF was associated with telomere shortening, but not tenofovir disoproxil. [2]\u00a0<\/strong><\/p>\n

This was in 121 HIV positive people initialling assessed from 2003\u20137 and again a median of 12 years later, but this had the significant limitation that baseline samples were not available on TAF because it was not yet available.<\/strong><\/p>\n<\/div>\n

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References<\/span><\/p>\n<\/div>\n

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  1. Schoepf IC et al for the Swiss HIV Cohort Study. Telomere length declines in persons living with HIV before antiretroviral therapy start but not after viral suppression: a longitudinal study over >17 years. J Infect Dis. 2021 Dec 15:jiab603. doi: 10.1093\/infdis\/jiab603. (21 December 2021).
    \nhttps:\/\/pubmed.ncbi.nlm.nih.gov\/34910812<\/a><\/li>\n
  2. Upal R et al. Tenofovir alafenamide is associated with shorter telomere length in people with HIV. CROI 2022. Poster abstract 625.
    \n    https:\/\/www.croiconference.org\/abstract\/tenofovir-alafenamide-is-associated-with-shorter-telomere-length-in-people-with-hiv\/<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base Results from a 17-year study report that untreated HIV is associated with significant reductions in telemere length (TL) but that effective ART stopped further damage. [1] TL is associated with ageing, coronary artery disease (CAD) and …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31,15,170],"tags":[],"class_list":["post-42052","post","type-post","status-publish","format-standard","hentry","category-opportunistic-infections-coinfections-and-complications","category-basic-science-and-immunology","category-ageing-and-life-expectancy"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/42052","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=42052"}],"version-history":[{"count":1,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/42052\/revisions"}],"predecessor-version":[{"id":44233,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/42052\/revisions\/44233"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=42052"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=42052"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=42052"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}