Can NAD+ Benefit Those Suffering from HIV and Aging?

Can NAD+ Benefit Those Suffering from HIV and Aging?

Fourteen years ago, September 18, 2008, the National Institute of Aging (NIA) launched National HIV and Aging Awareness Day. In the late 80s, very few people that were diagnosed with what is now known as human immunodeficiency virus (HIV) were lucky to survive past a year. During that time, many of the people living with HIV were taking highly toxic prescriptions and staying silent in hopes of surviving an epidemic. As treatments got better so did the lives of those suffering in silence. Although the HIV drugs used now are more effective and less toxic than drugs used in earlier times, they still may have long-term effects that we do not yet fully understand. So it’s not a surprise as we are hearing more people surviving to the normal lifespan.

The Ryan White HIV/AIDS Program (ADAP) serves over half a million individuals over 50 with HIV. In 2019, 92.2% of those aged 50 and older receiving HIV medical care were virally suppressed, which was higher than the national average (88.1%).

According to the Centers for Disease Control and Prevention (CDC), in 2018, over half (51%) of people in the United States that are diagnosed HIV were aged 50 and older. In addition, people aged 50 and older accounted for 17% of the 37,968 new HIV diagnoses. Though new HIV diagnoses are declining among people aged 50 and older, around 15% of diagnosis were those classified to be HIV and aging group.

People living with HIV have a lot more issues related to their aging than their HIV-related illnesses. Many individuals with HIV who have been living with it since the very beginning of the epidemic have unique difficulties, both physically and psychologically. 

How Does HIV Affect the Body’s Aging Process

HIV has an “early and substantial” impact on aging in infected people, accelerating biological changes in the body associated with normal aging within just two to three years of infection, according to a study by UCLA researchers and colleagues.

The findings suggest that new HIV infection may rapidly cut nearly five years off an individual’s life span relative to an uninfected person.

“Our work demonstrates that even in the early months and years of living with HIV, the virus has already set into motion an accelerated aging process at the DNA level,” said lead author Elizabeth Crabb Breen, a professor emerita at UCLA’s Cousins Center for Psychoneuroimmunology and of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA.

“This emphasizes the critical importance of early HIV diagnosis and an awareness of aging-related problems, as well as the value of preventing HIV infection in the first place.”

Living with HIV presents certain challenges, no matter what your age. But older people with HIV may face different issues than their younger counterparts, including greater social isolation and loneliness. The aging process itself can lower energy levels, restrict social encounters, and cause decreased physical and mental abilities. This means that older people living with HIV may suffer more emotional problems and physical stresses than others do.

Stigma can also make things difficult. There is the stigma from shame of living with HIV, AIDS, and older adults. This can make it difficult for older people to find support. First of all, they may be ashamed and hesitate to tell anyone that they live with HIV. Secondly, they may not be comfortable in support groups that include younger people.

In the late 80s many HIV cocktails (ART) regimens required people to take several pills around the clock. Even today with the huge improvements in HIV drugs that now allow most people to live long and healthy lives with HIV, there are several ways in which living and aging with HIV are different than others over 50 years old.

HIV and its treatment can also have effects on the brain. Researchers estimate that between 25 and 50% of people with HIV have HIV-Associated Neurocognitive Disorder (HAND), a spectrum of cognitive, motor, and/or mood disorders categorized into three levels: asymptomatic, mild, and HIV-associated dementia. Researchers are studying how HIV and its treatment affect the brain, including the effects on older people living with HIV.

Can NAD+ Slow Aging for those Aging with HIV?

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme that’s been shown to slow aging and help people fight the ill effects of aging. As biohacking evolves it’s been found to mitigate age-related disorders by regenerating the human body’s mitochondria. NAD+ is a key enzyme found in human cells and has been shown to reduce the amount of age-related tissue damage and by increasing the nutrients that keep skin looking young. It also improves muscle function and endurance and helps ward off age-related diseases. Recent research has shown that NAD+’s rehabilitation power extends the cells.

“We report that HIV-1 infection of human cells in vitro leads to significant decreases in the intracellular concentration of NAD. This decrease varies with viral load and HIV strain. In tissue culture, cells lacking CD4 receptors or cells incubated with heat inactivated virus do not demonstrate this decrease in NAD. Nicotinamide, the amide form of the vitamin niacin, increases intracellular NAD levels in uninfected cells as expected. Our data demonstrate that nicotinamide also maintains increased intracellular NAD concentrations in HIV infected cells. We conclude that HIV induces a state of intracellular pellagra which is reversed by the administration of nicotinamide.”

The team examined five epigenetic measures of aging. Four of them are what are known as epigenetic “clocks,” each of which uses a slightly different approach to estimate biological age acceleration in years, relative to chronological age. The fifth measure assessed the length of telomeres, the protective cap-like ends of chromosomes that become progressively shorter with age as cells divide, until they become so short that division is no longer possible.

“Our access to rare, well-characterized samples allowed us to design this study in a way that leaves little doubt about the role of HIV in eliciting biological signatures of early aging,” said senior author Beth Jamieson, a professor in the division of hematology and oncology at the Geffen School. “Our long-term goal is to determine whether we can use any of these signatures to predict whether an individual is at increased risk for specific aging-related disease outcomes, thus exposing new targets for intervention therapeutics.”

If you feel good about your age, it can help your health. As the saying goes, you’re only as old as you feel!

Sources

Research from the National Library of Medicine*

HIV Services Locator