First-of-its-Kind Study Reveals Accelerated Aging in Women with HIV

Accelerated epigenetic aging was found in women with HIV (WWH) compared with women without HIV, according to a new study published in The Journal of Infectious Diseases.

In a first-of-its-kind study where only women were sampled, epigenetic aging — an individual’s degree of aging based on patterns of DNA changes — was associated with lower physical function in women with HIV and in women without HIV.

Epigenetic aging estimates have revealed accelerated aging in adults with HIV, mainly in male-dominated samples. However, it's important to recognize that globally, more than 50% of individuals living with HIV are women. In 2021, women constituted an estimated 49% of all new infections.

Furthermore, DNA methylation, a commonly researched epigenetic modification, correlates with accelerated epigenetic aging, according to the study.

In association with accelerated aging, women with HIV experienced higher rates of bone loss compared with women without the virus, which can place them at increased risk of fracture as they age, based on results from the Women’s Interagency HIV Study. This study looked at pre-, peri-, and post-menopausal women, and researchers found that WWH had lower areal bone mineral density (aBMD) by dual energy X-Ray absorptiometry (DXA) and lower volumetric bone mineral density by quantitative computed tomography than age- and race or ethnicity-matched women without HIV.

Researchers of the latest study analyzed the relationship between accelerated epigenetic aging and musculoskeletal outcomes in women with HIV because it has not been studied in the past. In this new study, researchers compared DNA methylation-based biomarkers of aging between women with HIV and women without HIV and evaluated associations of epigenetic age acceleration with bone mineral density and physical function.

Researchers used a chip, the Infinium MethylationEPIC BeadChip, to look at DNA methylation age in a group of 190 women from the Women's Interagency HIV Study. They also measured bone mineral density and physical function. The study also looked at six markers related to epigenetic aging: epigenetic age acceleration (EAA) and extrinsic and intrinsic epigenetic age acceleration, as well as DNA methylation–estimated telomere length.

The researchers wanted to see how these markers were connected to bone mineral density and physical function. They also did broader analysis to explore the links between DNA methylation patterns and bone mineral density, as well as physical function.

Out of 118 women with HIV and 72 women without, women with the disease showed higher epigenetic aging and lower DNA methylation–estimated telomere length compared with those without HIV. There were no significant connections found between epigenetic aging and bone mineral density, however, measures of epigenetic aging was linked to lower levels of physical function.

The study is limited by its cross-sectional design, capturing information at a specific point in time and preventing researchers from determining whether changes in physical function could lead to changes in DNA methylation. Researchers didn't consider factors such as inflammatory biomarkers or other elements that might be linked to these type of changes. In addition, the researchers didn't collect specific data on bone or muscle that could highlight those changes.

Study authors note, however, that women without HIV in the study had higher rates of using tobacco, cocaine and alcohol. Because these substances being known for their association with faster epigenetic aging, the study's findings of accelerated aging in women with HIV are more concerning with drug use.

"The work demonstrates that women living with HIV experience an accelerated aging process at the DNA level, and that this aging process may be linked to functional outcomes," the study’s lead author, Stephanie Shiau, an assistant professor in the Department of Biostatistics and Epidemiology at the Rutgers School of Public Health, said in a press release. “Future studies will need to see whether these findings are observed longitudinally.”