Treatment of HIV with ART Slows Advanced Biological Aging Process

By: Marcus J. Hopkins, Health Policy Lead Consultant, ADAP Advocacy

Research presented at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global conference in Munich, Germany, has found that early initiation of antiretroviral therapy (ART) for HIV reduces accelerated aging in people living with the virus (Ryan et al., 2026).

Photo Source: ESCMID

While this research is currently in pre-print form, meaning that it has not been peer reviewed for final publication, it could help to provide additional ammunition in the argument that initiating ART as soon as possible can help People Living with HIV/AIDS (PLWHA) live longer, healthier lives.

Researchers developed a plasma proteomic aging clock (PAC)—a tool used to estimate biological age, measuring the age of the body, as opposed to chronological age which measures a body’s age in terms of birth year to present. During the period prior to initiating ART, the PAC estimated that participants’ biological age was accelerated by a median of 10 years. With effective ART, this was reduced by nearly four years. 

How Does HIV Cause Accelerated Aging?

Research has suggested that, soon after the acquisition of HIV, the virus causes the human body to begin an accelerated aging process at the DNA level, contributing to the earlier onset of age-related diseases, such as heart and kidney diseases, medical and physical frailty, and cognitive difficulties (Rivero, 2022). Research published in 2022 found that this accelerated aging process begins within three years of the initial acquisition (Breen et al., 2022).

Earlier research also found that PLWHA may experience lipodystrophy—abnormal fat distribution—in both treated and untreated HIV, which can include the loss of subcutaneous fat in the face, extremities, and buttocks, as well as an increase in fat in the abdominal area, breasts, or at the top of the back, known as “buffalo hump.” This research also found that a combination of metabolic and immunologic changes can cause or exacerbate cardiovascular disease in PLWHA (Meir-Shafrir & Pollack, 2012).

Photo Source: MEDXY

What Does This Mean for People Living with HIV/AIDS?

Prior to 2012, people who had been diagnosed with HIV were not advised to begin ART until they had received an AIDS diagnosis after their CD4 (T-cell) count had fallen below 200 per microliter of blood (Castro et al., 1992). In March 2012, the Centers for Disease Control and Prevention (CDC) updated its treatment recommendations to recommend beginning ART as soon as possible, rather than waiting for an AIDS diagnosis (CDC, 2012).

This change has led to an overall decrease in the number of new diagnoses, in no small part due to the fact that PLWHA who are receiving ART and are virally suppressed have been shown to be unable to transmit the virus through sexual contact (CDC, 2024).

For PLWHA, early initiation of ART can help to slow down the accelerated aging process. This is true, also, for those currently receiving ART, which makes remaining on treatment and being virally suppressed even more important.

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References:

[1] Breen, E. C., Sehl, M. E., Shih, R., Langfelder, P., Wang, R., Horvath, S., Bream, J. H., Duggal, P., Martinson, J., Wolinsky, S. M., Martinez-Maza, O., Ramirez, C. M., & Jamieson, B. D. (2022, July 15). Accelerated aging with HIV occurs at the time of initial HIV infection. iScience, 25(7), 104488. https://doi.org/10.5041/RMMJ.10089

[2] Castro, K. G., Ward, J. W., Slutsker, L., Buehler, J. W., Jaffe, H. W., Berkelman, R. L., & Curran, J. W. (1992, December 18). 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults. MMWR, 41(RR-17). https://www.cdc.gov/mmwr/preview/mmwrhtml/00018871.htm

[3] Centers for Disease Control and Prevention. (2012). Changes in US HIV Treatment Guidelines [Transcript]. Atlanta, GA: United States Department of Health and Human Services: Centers for Disease Control and Prevention: Audio Rounds. https://tools.cdc.gov/podcasts/media/pdf/AudioRounds_HIV_Tx_Guidleines.pdf

[4] Centers for Disease Control and Prevention. (2024, October 24). HIV Treatment as Prevention. Atlanta, GA: United States Department of Health and Human Services: Centers for Disease Control and Prevention: HIV Public Health Partners: HIV Treatment. https://www.cdc.gov/hivpartners/php/hiv-treatment/index.html

[5] Meir-Shafrir, K. & Pollack, S. (2012, October). Accelerated Aging in HIV Patients. Rambam Maimonides Medical Journal, 3(4), e0025. https://doi.org/10.5041/RMMJ.1008

[6] Rivero, E. (2022, June 30). Study shows HIV speeds up body’s aging processes soon after infection. Los Angeles, CA: University of California Los Angeles: UCLA Health: News: Release. https://www.uclahealth.org/news/release/study-shows-hiv-speeds-up-bodys-aging-processes-soon-after

[7] Ryan, B., Oumelloul, M. A., Rouached, S., Juillerat, A. D., Giacccheto, L., Thorball, C. W., Schoepf, I. C., Arribas, J. R., Soldevila, B. R., Kootstra, N., Reiss, P., Jackson-Perry, D., Haerry, D. H-U., Günthard, H. F., Bartl, L., Dollé, C., Russenberger, D., Nanni, P., Kockmann, T., … Tarr, P. E. (2026, March 26). A Plasma Proteomic Ageing Clock Reflects Advanced Ageing in People with Untreated HIV and its Reduction Under Antiretroviral Therapy. medRxiv. https://doi.org/10.64898/2026.03.24.26348875