scholarly journals Vaccine responses in ageing and chronic viral infection

Author(s):  
Chloe Rees-Spear ◽  
Laura E McCoy

Abstract Lay Summary Improved life expectancy in recent years has led to a growing population of adults over the age of 60. Age is commonly associated with increased inflammatory conditions and infections. Similar immunological changes have been observed during chronic infections, in particular HIV, where this is compounded by the success of antiretroviral therapy that has increased the number of people living with HIV into their sixties and beyond. The increased susceptibility of these groups to infection makes vaccination all the more important. However, the alterations to their immune systems call into question how effective those vaccinations may be. Here we discuss vaccine efficacy within elderly and chronically infected populations and investigate the immunological changes that may impact vaccine responsiveness. Over the last few decades, changing population demographics have shown that there is a growing number of individuals living past the age of 60. With this expanding older population comes an increase in individuals that are more susceptible to chronic illness and disease. An important part of maintaining health in this population is through prophylactic vaccination, however, there is growing evidence that vaccines may be less effective in the elderly. Furthermore, with the success of anti-viral therapies, chronic infections such as HIV are becoming increasingly prevalent in older populations and present a relatively unstudied population with respect to the efficacy of vaccination. Here we will examine the evidence for age-associated reduction in antibody and cellular responsiveness to a variety of common vaccines, and investigate the underlying causes attributed to this phenomenon, such as inflammation and senescence. We will also discuss the impact of chronic viral infections on immune responses in both young and elderly patients, particularly those living with HIV, and how this affects vaccinations in these populations.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 848-848
Author(s):  
Lynn Tepper

Abstract Although HIV became known during the decade of the 1980’s, it was not until 1987 that the WHO launched the Global Program on AIDS to raise awareness, generate evidence-based policies, and provide technical and financial support to conduct research, promote NGO participation, and promote the rights of people living with HIV. It was then also that robust educational and prevention initiatives began to take place. At this time, a Columbia University study, led by Dr. Lynn Tepper, a gerontologist, initiated a study to see if the older population fully understood the disease and the practice of prevention behaviors, as they were not a specific target for AIDS education and prevention. This led to the establishment of the AIDS and the Elderly Interest Group, sponsored by GSA, in an attempt to know more about the impact of AIDS in the older population. Part of a symposium sponsored by the HIV, AIDS and Older Adults Interest Group.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristie C. Waterfield ◽  
Gulzar H. Shah ◽  
Gina D. Etheredge ◽  
Osaremhen Ikhile

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Marie Libérée Nishimwe ◽  
Christopher Kuaban ◽  
Sylvie Boyer

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.


Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215866
Author(s):  
Ana I Hernandez Cordero ◽  
Chen Xi Yang ◽  
Maen Obeidat ◽  
Julia Yang ◽  
Julie MacIsaac ◽  
...  

IntroductionPeople living with HIV (PLWH) suffer from age-related comorbidities such as COPD. The processes responsible for reduced lung function in PLWH are largely unknown. We performed an epigenome-wide association study to investigate whether blood DNA methylation is associated with impaired lung function in PLWH.MethodsUsing blood DNA methylation profiles from 161 PLWH, we tested the effect of methylation on FEV1, FEV1/FVC ratio and FEV1 decline over a median of 5 years. We evaluated the global methylation of PLWH with airflow obstruction by testing the differential methylation of transposable elements Alu and LINE-1, a well-described marker of epigenetic ageing.ResultsAirflow obstruction as defined by a FEV1/FVC<0.70 was associated with 1393 differentially methylated positions (DMPs), while 4676 were associated with airflow obstruction based on the FEV1/FVC<lower limit of normal. These DMPs were enriched for biological pathways associated with chronic viral infections. The airflow obstruction group was globally hypomethylated compared with those without airflow obstruction. 103 and 7112 DMPs were associated with FEV1 and FEV1/FVC, respectively. No positions were associated with FEV1 decline.ConclusionA large number of DMPs were associated with airflow obstruction and lung function in a unique cohort of PLWH. Airflow obstruction in even relatively young PLWH is associated with global hypomethylation, suggesting advanced epigenetic ageing compared with those with normal lung function. The disturbance of the epigenetic regulation of key genes not previously identified in non-HIV COPD cohorts could explain the unique risk of COPD in PLWH.


Sexual Health ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. 111 ◽  
Author(s):  
Graham Brown ◽  
William Leonard ◽  
Anthony Lyons ◽  
Jennifer Power ◽  
Dirk Sander ◽  
...  

Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM’s access to and use of these technologies. At the personal level, stigma can affect individual gay men’s sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM’s incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.


2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.


2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.


2016 ◽  
Vol 9 (1) ◽  
pp. 31999 ◽  
Author(s):  
Mayumi Shimizu ◽  
Siyan Yi ◽  
Sovannary Tuot ◽  
Samedy Suong ◽  
Samrithea Sron ◽  
...  

2016 ◽  
Vol 21 (3) ◽  
pp. 766-782 ◽  
Author(s):  
John A. Maluccio ◽  
Fan Wu ◽  
Redwan B. Rokon ◽  
Rahul Rawat ◽  
Suneetha Kadiyala

2021 ◽  
Vol 11 (33) ◽  
pp. 99-106
Author(s):  
Luciária Silva Souza ◽  
Naiane Pereira dos Santos ◽  
Pollyanna Viana Lima ◽  
Isnara Teixeira Brito Melo ◽  
Alessandra Souza de Oliveira ◽  
...  

O presente artigo tem como objetivo identificar a funcionalidade familiar em pessoas idosas convivendo com HIV/AIDS. Trata-se de um estudo de caráter exploratório, descritivo com abordagem quanti-qualitativa, desenvolvida em um Centro de Atenção e Apoio especializado de referência em atendimento para pessoas convivendo com IST’s e HIV/AIDS em um município baiano com 26 pessoas idosos. Utilizou-se roteiro semi-estruturado para entrevista e questionário com dados sociodemográficos e de saúde e o Apgar da família, para avaliação da funcionalidade familiar. Verificou-se no estudo que a maior parte das pessoas idosas diagnosticadas com HIV/AIDS deste estudo convivem em uma família disfuncional grave (34,61%), o que corrobora para que a grande maioria dos idosos mantenham em sigilo o diagnóstico da doença para o seu núcleo familiar, outros convivem com a estigmatização o isolamento e o preconceito. Conclui-se que os idosos convivem em uma família disfuncional grave, com repercussões negativas para o enfretamento da doença.Descritores: Idoso, Funcionalidade Familiar, HIV, AIDS. Assessment of family functionality in elderly people living with HIV/AIDSAbstract: This article aims to identify family functionality in elderly people living with HIV/AIDS. This is an exploratory, descriptive study with a quantitative and qualitative approach, developed in a specialized Care and Support Center of reference in care for people living with STIs and HIV/AIDS in a municipality in Bahia with 26 elderly people. A semi-structured script was used for the interview and questionnaire with sociodemographic and health data and the family Apgar, to assess family functionality. It was found in the study that most elderly people diagnosed with HIV/AIDS in this study live in a severe dysfunctional family (34.61%), which corroborates that the vast majority of the elderly keep the diagnosis of the disease confidential. their family nucleus, others live with stigmatization, isolation and prejudice. It is concluded that the elderly live in a severe dysfunctional family, with negative repercussions for coping with the disease.Descriptors: Elderly, Family Functionality, HIV, AIDS. Evaluación de la funcionalidad familiar en personas mayores que viven con VIH/SIDAResumen: Este artículo tiene como objetivo identificar la funcionalidad familiar en personas mayores que viven con VIH / SIDA. Se trata de un estudio exploratorio, descriptivo con enfoque cuantitativo y cualitativo, desarrollado en un Centro de Atención y Apoyo especializado de referencia en la atención a personas viviendo con ITS y VIH / SIDA en un municipio de Bahía con 26 ancianos. Se utilizó un guión semiestructurado para la entrevista y cuestionario con datos sociodemográficos y de salud y el Apgar familiar, para evaluar la funcionalidad familiar. En el estudio se encontró que la mayoría de las personas mayores diagnosticadas con VIH / SIDA en este estudio viven en una familia disfuncional severa (34,61%), lo que corrobora que la gran mayoría de las personas mayores mantienen confidencial el diagnóstico de la enfermedad. su núcleo familiar, otros viven con estigmatización, aislamiento y prejuicio. Se concluye que los ancianos viven en una familia severamente disfuncional, con repercusiones negativas para el afrontamiento de la enfermedad.Descriptores: Anciano, Funcionalidad Familiar, VIH, SIDA.


Sign in / Sign up

Export Citation Format

Share Document