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HIV, Cancer and Immunity
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In this talk Grulich discussed concerns about aging and the risk for some cancers where we might see increased rates. Of course I think it's a given that some cancers and other non-AIDS events will increase as we age.
From Jules: The last oral session on Wed at CROI from 4-6pm was on Long-Term Complications where Andrew Grulich gave a talk on cancers in HIV. He said cancers were associated with immunodeficiency, which many studies show, but I went to the microphone and said there may be additional reasons besides just association with CD4 count. In the earlier days of HIV we used to talk about finding holes in the T-cell repertoire for patients with HIV, which might mean that although CD4 counts increase to good levels there could remain a 'hole' in the immune system whereby a certain immune deficiency might persist such that in the future there may be a lacking against certain potential challenges to the immune system. Of course he disagreed with me from the podium, but after I commented back to him he said 'well I'm not an immunologist'. Another potential concern I didn't mention at the microphone is that HIV appears to accelerate aging. A recently published study in Feb JAIDS found from an in vitro study that HIV causes a phenotypic change in naive and memory T-cells so that the changed phenotype (type of cells) are like those found in aging HIV-negative individuals. In other words, HIV accelerates the aging process, accelerates and causes decline in the immune system's ability to deal with morbidities or conditions that emerge as people age. The thinking is that HIV+ individuals at age 65 may be like HIV-negative individuals when they are 80 yrs old.
Researchers must look into this concern that HIV accelerates aging and changes the T-cell repertoire so that perhaps we might understand this and perhaps figure out how to intervene; if we don't look into this we are not likely to solve the premature aging problem in HIV.
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