PLAY HIGH - Premature acceLerated Ageing in Young HIV-infected Individuals: Global researcH initiative
Pediatric HIV is major plague with about 1.8 million children living with HIV, yet only half of them have access to ART, and more than 100.000 die each year of AIDS-related illnesses. Figures get worse when children grow as, during adolescence, they start sexual activity thus increasing the risks of getting infected. Therefore, it is crucial to target these age groups (children and adolescents) to reach the 90-90-90 goal.
HIV infection is associated with premature ageing. This phenomenon occurs also in HIV-infected children and adolescents and includes signs of immunosenescence and increased risk of cardiovascular disease (CVD). ART cannot completely restore these signs and, in some cases, even worsens CVD risk and dyslipidemia. However, little is known about the mechanisms responsible for premature ageing, especially in young HIV-infected individuals.
The consequence of premature ageing (e.g. non-AIDS defining conditions; diminished response to vaccine and co-infections) are extremely relevant from a public health perspective; however, only few studies describing these condition in young HIV-infected children are available, and a comprehensive research characterizing the different aspects of premature ageing in young HIV-infected individuals is missing.
Lipid metabolism seems to be involved in all major signs of premature ageing: dyslipidemia is associated with higher CVD risk, and lipids have shown a controversial effect on adaptive immune responses and, even so, on immune-ageing. Thus, systemic metabolic dysregulation caused by HIV infection and ART may cause immune suppression and premature immunosenescence in HIV-infected individuals. However, the linkage between HIV-infection, CVD, lymphocyte metabolism and immunosenescence is unknown.
Through this study, the 4 participants (Francesco Nicoli, University of Ferrara, Italy; Mkunde Chachage, Mbeya Medical Research Center, Tanzania; Deepak Paudel, Save the Children, Nepal; María Teresa Solis Soto, San Francisco Xavier de Chuquisaca University, Bolivia) aimed at establishing an international network to facilitate and initiate the collection of epidemiological and biological evidences aimed at comprehensively assessing the premature aging in children and adolescents infected by HIV, by studying the different phenomena that characterize this status, with particular regards toward CVD, immunosenescence and immunometabolism.