Cytomegalovirus and HIV: A Dangerous Pas de Deux

J Infect Dis. 2016 Oct 1;214 Suppl 2(Suppl 2):S67-74. doi: 10.1093/infdis/jiw217.

Abstract

Human immunodeficiency virus (HIV)-infected adults who take stable antiretroviral therapy (ART) are at risk for early onset of age-related diseases. This is likely due to a complex interaction between traditional risk factors, HIV infection itself, and other factors, such as underlying immune dysfunction and persistent inflammation. HIV disrupts the balance between the host and coinfecting microbes, worsening control of these potential pathogens. For example, HIV-infected adults are more likely than the general population to have subclinical bursts of cytomegalovirus (CMV) replication at mucosal sites. Production of antigens can activate the immune system and stimulate HIV replication, and it could contribute to the pathogenesis of adverse outcomes of aging, like cardiovascular disease and neurocognitive impairment. Further investigation of the relationships between CMV, immune dysfunction, and unsuccessful aging during chronic HIV infection is warranted.

Keywords: HIV; aging; cytomegalovirus; end organ disease; immune dysfunction; inflammation.

Publication types

  • Review

MeSH terms

  • Aging* / immunology
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Coinfection
  • Cytomegalovirus
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / immunology
  • Disease Progression
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV-1
  • Humans
  • Neurocognitive Disorders / etiology