Grant: Doctoral Research Award - PA: Drug Safety and Effectiveness

Over 37 million people live with HIV globally. In Canada, there are over 75000 persons living with HIV, with a new HIV infection every 3 hours. HIV is currently treated with combination antiretroviral therapy (cART), a mixture of three different anti-HIV drugs. This allows people with HIV to live longer and prevents death from Acquired Immunodeficiency Syndrome (AIDS). However, despite successful treatment, people with HIV are still more likely to suffer from diseases that usually occur with old age. These include heart, bone, and liver diseases, as well as certain cancers. A rapidly-aging immune system is suspected to lead to these age-related diseases, but it is unclear whether this results from the virus (HIV) or the treatment (cART). Although people with HIV are known to have older immune cells, it is unknown which types of immune cells are affected. In addition, approximately 1% of people with HIV are "non-progressors", and remain healthy without treatment. We do not know how the virus affects aging in their immune systems. I will separate blood samples from 400 participants into specific types of immune cells, and measure parameters that are related to cellular aging. Then, I will compare the results between HIV+ (treated and untreated) and HIV- people, while examining other factors that may predict the age of their immune cells (such as age, amount of HIV virus in blood, and other viral infections). I will also determine if the virus affects non-progressors the same way, and whether they should get treatment even if they appear healthy. Our findings will clarify how HIV accelerates immune system aging, something that may predict many diseases. In North America, most people with HIV will be over 50 years old within 5 years, which means more will struggle with HIV and age-related diseases than ever. This study will provide a deeper understanding of how HIV may lead to these diseases and how to better care for people living with the virus.