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First HIV link to frailty and ageing diseases

Angus Morgan

01 August, 2017

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Quality of life and health outcomes for people who are HIV-positive and at high risk of frailty and age-related diseases are set to be enhanced by new Burnet Institute research into the impact of HIV on immune cells.

Published in the journal EBioMedicine, the research shows for the first time a link between the way immune cells use energy and ageing diseases in HIV-positive men.

Led by Dr Clovis Palmer, the study is the first to investigate frailty in HIV-positive men in Australia, with potential health benefits for the approximately 50 percent of HIV-positive men in developed countries who are aged 50-plus.

While these men are living longer with HIV thanks to antiretroviral therapy (ART), they’re at higher risk of comorbidities such as liver disease, cancer, cardiovascular disease and frailty, driven by an acceleration of ageing of the immune system and the body by the virus.

Dr Palmer’s study set out to investigate the incidence of frailty in Australia and understand its biological basis by testing blood samples from 80 HIV-positive men with a median age of 59 years, all of whom were on ART.

Study first author Dr Hui Ling Yeoh assessed 24 percent of these men as frail – having diminished strength, mobility and mental acuity, and a lower quality of life than those who were not frail.

“It’s well known that inflammation, the body’s defence against external threats like a bacteria or virus, underpins the increased risk of age-associated diseases,” Dr Palmer, the Head of Burnet’s HIV Immunometabolism laboratory, said.

“While inflammation is increased in the setting of HIV infection, no-one had examined the fundamental process in immune cells that links inflammation in HIV-positive people and the development of frailty.

“So we focused on how HIV changes the way immune cells use energy or nutrients like glucose. We focused on glucose because immune cells use glucose for energy.”

The researchers found that instead of using glucose for energy to fight infection, immune cells in HIV-infected frail individuals take up glucose to produce toxic molecules, and it’s this that’s driving inflammation.

Dr Palmer’s team also discovered high levels of particular toxic lipids or fats in the blood samples of frail participants, providing a potential marker for new diagnostic tests for frailty and age-related diseases.

“This research shows for the first time a link between the way immune cells use energy and frailty in people with HIV, and of course it has broader implications for the general public in terms of other ageing diseases as well,” Dr Palmer said.

“Everyone living with HIV is potentially at risk of developing frailty and other related comorbidities, and this risk increases in middle-aged and elderly men.

“We are now investigating how we can improve the way immune cells utilise energy, which would be the first step towards stopping or minimising chronic inflammation in HIV-positive patients, with the ultimate aim to improve their quality of life.”

The anticipated next research step is to broaden the study to include examination of cells from HIV-positive individuals in resource limited countries to further examine biomarkers for frailty and other comorbidities and to further examine the efficacy of novel anti-inflammatory compounds towards the development of new therapeutics.

This research was conducted in collaboration with Alfred Health, Monash University, Baker Heart and Diabetes Institute and University of the Witwatersrand, and funded by Merck Sharp & Dohme.

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Contact Details

For more information in relation to this news article, please contact:

Doctor Clovis Palmer

Head, Palmer Laboratory, Adjunct Senior Lecturer, Monash University, Department of Infectious Diseases

Telephone

+61385062389

Email

clovis.palmer@burnet.edu.au

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