Age Acceleration

Antiretroviral medications have allowed HIVers to live longer and manage their viral load, but the drugs also sometimes have harmful, toxic side effects. A recent example comes from new research by the Institute of Genetic Medicine at the U.K.'s Newcastle University, which indicates that the older antiretrovirals are primary culprits in premature aging. Aging is simply a process of naturally occurring errors on a microscopic level, says Newcastle University professor Patrick Chinnery, MD. As we age, our DNA's mitochondria'the 'batteries' that power our cells'get copied repeatedly, leading to so-called natural errors. Essentially, that's the process of aging, which leads to frailty, dementia, cardiovascular disease, and other age-related afflictions. Research from Chinnery's team shows that older antiretroviral drugs, like zidovudine (AZT), accelerate the rate at which the errors accumulate. 'So over the space of, say, 10 years, a person's mitochondrial DNA may have accumulated the same amount of errors as a person who has naturally aged 20 or 30 years,' Chinnery said. 'What is surprising, though, is that patients who came off the medication many years ago may still be vulnerable to these changes.' These older drugs are less commonly used in the United States and Europe due to concerns about toxicity. But because these drugs are less expensive than when they were introduced, people in low-income countries have become their primary consumers. Brendan Payne, MD, a British HIV specialist and coauthor of the study, said that these drugs, even with their side effects, still have been able to help countless low-income people manage their HIV. 'These drugs may not be perfect, but we must remember that when they were introduced they gave people an extra 10 or 20 years when they would otherwise have died,' he said. 'In Africa, where the HIV epidemic has hit hardest and where more expensive medications are not an option, they are an absolute necessity.'