Cytomegalovirus In HIV: A Modifiable Driver Of Inflammation, Frailty, And Aging
Many individuals living with HIV also carry the cytomegalovirus (CMV), a common virus that persists in the body despite effective HIV treatment. This co-infection significantly contributes to a state of chronic inflammation, which is a persistent, low-grade inflammatory response throughout the body. It also accelerates what scientists call “immune senescence” or “biological aging,” essentially speeding up the natural decline of the immune system and the body’s overall aging process.
When CMV reactivates, it triggers several changes within the body. It causes an increase in specific immune cells called T-cells (known as clonal T-cell expansion), alters how the body’s initial defense system responds (innate immune reprogramming), leads to inflammation in fat tissue, and changes how the body processes energy (metabolic rewiring). These changes also include lasting modifications to how genes are expressed without altering the DNA itself (durable cellular epigenetic changes).
These effects collectively increase the risk for various health problems, including diseases affecting blood vessels, a state of increased vulnerability and weakness known as frailty, brain health disorders, diabetes, and certain cancers.
The good news is that CMV is a modifiable factor. Early research indicates that antiviral medications, such as letermovir, can help reduce inflammation and improve immune function and frailty outcomes in people with HIV. Additionally, vaccines against CMV are currently under development. By targeting CMV through antiviral treatments, vaccines, or other host-directed approaches, it may be possible to lessen the burden of multiple health conditions and promote healthier aging for individuals living with HIV, especially those at higher risk.
Source: link to paper