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T-cell immunity against cytomegalovirus in HIV infection and aging: relationships with inflammation, immune activation, and frailty

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Abstract

Both aging and treated human immunodeficiency virus (HIV) infection are characterized by low-level chronic inflammation and immune activation which contribute to the development of age-related diseases, frailty, and early mortality. Chronic cytomegalovirus (CMV) infection is highly prevalent in older adults and HIV-infected populations. A number of studies have shown that CMV induces broad and strong T-cell responses in CMV-seropositive older adults and HIV-infected individuals. CMV infection rarely develops into clinical disease in immunocompetent individuals. However, a large body of literature has shown adverse effects of chronic CMV infection on the health and longevity of these populations. It has been hypothesized that chronic CMV infection may be a driver of chronic inflammation and immune activation, and may further contribute to the development of frailty. Thus, there is a need to better understand the extent of the impact of chronic CMV infection on T-cell immunity and health in aging and HIV infection. In this review, we will address important considerations and challenges in the assessment of chronic CMV infection and CMV-specific T-cell responses. We will then review recent data on relationships between T-cell responses to CMV and levels of inflammatory markers and immune activation, as well as the onset of frailty.

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Acknowledgements

Work presented in this review was supported in part by NIH Grants R21-AG-043874 and R01AI108907 to Dr. Sean X. Leng, U01-AI35042 (MACS) to Dr. Joseph B. Margolick, and Irma and Paul Milstein Program for Senior Health, Milstein Medical Asian American Partnership (MMAAP) Foundation (http://www.mmaapf.org) to Dr. Sean X. Leng.

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Author notes

  1. Juliette Tavenier

    Present address: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark

  2. Joseph B. Margolick

    Present address: Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Room E5153, Baltimore, MD, 21205-7535, USA

  3. Sean X. Leng

    Present address: Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle-Room 1A.38A, Baltimore, MD, 21224, USA

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    1. Juliette Tavenier
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    Correspondence to Sean X. Leng.

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    Tavenier, J., Margolick, J.B. & Leng, S.X. T-cell immunity against cytomegalovirus in HIV infection and aging: relationships with inflammation, immune activation, and frailty. Med Microbiol Immunol 208, 289–294 (2019). https://doi.org/10.1007/s00430-019-00591-z

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