Biological Aging and Immune Senescence in Children with Perinatally Acquired HIV

Table 1

Summary of recent findings on telomeres on HIV-infected children, adolescents, and young adults.

Patients	Median age [IQR] (y.o.)	Telomere length median [IQR]	Method of telomere measure	Main findings	Authors and reference
94 pHIV	13.3 [9.9-15.8]	n.d.	Relative TL by rtPCR	Telomere attrition is similar for pHIV, HEU, and HUU. Older age and male gender are correlated with shorter TL. Detectable viremia and absence of ART are correlated with shorter TL.	Cote et al. [37]
177 HEU	1.7 [0.6-4.0]	n.d.
104 HUU	10.6 [5.3-14.2]	n.d.
71 pHIV	3.11 [1.40-4.48]	2.21 [1.94-2.58]	Relative TL by rtPCR	pHIV have significantly shorter TL than HEU and HUU. ART-naïve pHIV have shorter TL than pHIV on ART. Percentages of senescent, activated, and exhausted CD8 cells are higher in pHIV than in HEU and HUU.	Gianesin et al. [56]
65 HEU	1.74 [0.99-3.31]	2.63 [2.25-3.21]
56 HUU	1.85 [0.84-3.46]	2.88 [2.49-3.10]
324 HEU	≥1 samples 0-3 y.o.	n.d.	Relative TL by rtPCR	TL is similar between HEU and HUU. HIV and cART exposure in utero does not appear to alter telomere dynamics during early life.	Ajaykumar et al. [191]
306 HUU	1 sample 0-3 y.o.	n.d.
120 pHIV			Absolute TL by rtPCR	There was no evidence of accelerated biological aging by mDNA levels. Absolute telomere length was shorter in pHIV and HEU compared to HUU but did not differ between pHIV and HEU.	Shiau et al. [193]
33 HEU
25 HUU
94 HEU ZDV+	1.0 [0.0-7.0] days		Relative TL by rtPCR	TL of ZDV+HEU infants is longer compared to that of ZDV-HEU.	Wang et al. [192]
85 HEU ZDV-	1.0 [0.0-6.9] days
21 pHIV	27 [24-29]	1.0 [0.8-1.2]	Relative TL by rtPCR	TL and telomere shortening rate of pHIV and npHIV is significantly lower than that of HUU. pHIV and npHIV maintain a normal thymic output, with a continuous shift of the naïve pool into memory subsets. This phenomenon may allow to control viral infection and maintain peripheral homeostasis.	Paghera et al. [194]
19 npHIV	27 [24-29]	0.9 [0.7-1.2]
40 HUU	28 [24-31]	1.5 [1.3-1.9]

pHIV: perinatally HIV-infected children; npHIV: nonperinatally HIV-infected children; HEU: HIV-exposed uninfected children; HUU: HIV-unexposed uninfected children; HUU: HIV unexposed uninfected; ZDV: zidovudine; TL: telomere length; n.d.: values not reported in the original papers; values estimated from Figure 2A of Paghera et al. [194].