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HIV-mediated immune aging in young adults infected perinatally or during childhood

Fastenackels, Solènea; Sauce, Delphinea; Vigouroux, Corinneb,c; Avettand-Fènoël, Véroniqued; Bastard, Jean-Philippeb,e; Fellahi, Sorayab,e; Nailler, Lauraf; Arezes, Elisaf; Rouzioux, Christined; Warszawski, Josianef; Viard, Jean Paulg; Appay, Victora,h for the ANRS Co19 COVERTE Study Group

doi: 10.1097/QAD.0000000000002275

Background: HIV-infected patients progressing towards disease present a premature immune aging profile, characterized by the exhaustion of lymphopoiesis. The development of these anomalies may be prevented in young HIV-infected patients owing to their robust immune resources and lymphocyte regeneration capacities.

Methods: An immunomonitoring substudy was designed for young adults aged between 18 and 25 years, living with HIV since childhood included in the national ANRS Co19 COVERTE Cohort. We compared markers associated with immune aging, including the frequency of circulating hematopoietic progenitors and the phenotype of lymphocyte populations, with those of patients infected with HIV in adulthood.

Results: HIV-infected young adults displayed decreasing numbers of CD34+ hematopoietic progenitors and mature lymphocytes, indicative of general lymphopenia and reminiscent of the alterations found in patients infected in adulthood or uninfected elderly people. This highlights the strong impact of HIV on the immune system despite patient's young age at infection. Immune aging-related alterations were particularly obvious in young patients who presented high viral loads.

Conclusion: HIV-infected young adults can present increased markers of immune activation and senescence, related to uncontrolled viral replication. This highlights the issue of noncompliance to antiretroviral therapy in patients at a young age, resulting in loss of viral control, premature immunosenescence, and potentially irreversible damage of their lymphopoietic system.

aSorbonne Université, INSERM, Centre d’Immunologie et des Maladies Infectieuses (CIMI-Paris)

bSorbonne Université, Inserm UMR_S 938, Centre de Recherche Saint-Antoine

cAssistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service d’Endocrinologie, Diabétologie et Endocrinologie de la Reproduction, Laboratoire Commun de Biologie et Génétique Moléculaires, Centre National de Référence des Pathologies Rares de l’Insulino-Sécrétion et de l’Insulino-Sensibilité (PRISIS)

dAPHP, Laboratoire de Virologie, Hôpital Necker, EA 7327, Université Paris Descartes

eAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, UF Bio-marqueurs Inflammatoires et Métaboliques, Service de Biochimie et Hormonologie, Paris

fCESP 1018 INSERM, Team HIV/Pediatry, Université Paris-Saclay, AP-HP Hôpital Bicêtre, Le Kremlin-Bicêtre

gAHP, Centre de Diagnostic et de Thérapeutique, Hôpital de l’Hôtel-Dieu, EA 7327, Université Paris Descartes, Paris, France

hInternational Research Center of Medical Sciences (IRCMS), Kumamoto University, Kumamoto, Japan.

Correspondence to Victor Appay, CIMI-Paris, INSERM U1135, 91 Bd de l’Hôpital, 75013 Paris, France. Tel: +33 140778183; e-mail:

Received 22 January, 2019

Revised 23 April, 2019

Accepted 3 May, 2019

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Copyright © 2019 Wolters Kluwer Health, Inc.