Aging, HIV and Cytomegalovirus: Old Virus Meets New Tricks

The immune system and cytomegalovirus (CMV) have evolved a symbiotic relationship where the host enjoys enhanced protection against collateral infections, while CMV persists and spreads through the population. However, in modern society, diseases of affluence influence survival more than infectious pathogens, threatening the value of this symbiosis. The extended lifespan provided by medical and other advances has revealed a set of CMV-associated changes in the CD8+ T cell repertoire that signify increased risk for short-term mortality. These changes are literally, harbingers of death in the old elderly and markers of increased risk for multiple age-related disorders in the general population. Since the surfacing relationship between CMV and morbidity is predicated on features that are especially prominent in HIV-infected persons, the mechanisms by which CMV infection raises the risk for age-related morbidities may operate earlier and with greater intensity in the setting of HIV infection. This presentation will review ongoing and planned research addressing the role of CMV infection in emerging immune, neurological and cardiovascular disorders affecting HIV-infected persons and the elderly.