HIV-INFECTION AND AGING - MECHANISMS TO EXPLAIN THE ACCELERATED RATE OF PROGRESSION IN THE OLDER PATIENT

Age is an important predictor of progression in HIV infections. Not on ly do older individuals' develop AIDS more rapidly than younger person s, they die more quickly after developing an AIDS-defining illness. Wh ile the elderly have higher morbidity and mortality rates from viral a nd bacterial infections, the mechanism(s) responsible for the more rap id progression of HIV infection in older individuals has not been desc ribed. Our results demonstrate that the destruction of T cells in both young and old HIV infected patients progresses al the same rate. HIV 1-infected cells from older individuals do not appear more susceptible to immune mediated destruction. The more rapid progression appears du e to an inability of older persons to replace functional T cells that are being destroyed. These findings suggest that improved survival in older HIV infected individuals will require more aggressive antiretrov iral therapies as well as continued research to identify and preserve immune system elements that control the virus. (C) 1997 Elsevier Scien ce Ireland Ltd.