Aging HIV Drugs?

Older antiretroviral drugs used to treat HIV appear to age patients prematurely

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Much has been said about the exciting results achieved with antiretroviral drugs in treating HIV. They are groundbreaking, extending lives and helping eradicate the spread of these diseases.

A recent published study reveals that the older antiretroviral drugs, the most well known of which is zidovudine (AZT), typically used in third world countries, age cells and give patients taking these drugs a much older appearance.

These drugs are rarely used in the United States. But in sub-saharan Africa, where HIV is an epidemic, these inexpensive drugs are used quite commonly.

"Ask your doctor about antiretroviral drugs if you are infected with HIV."

Professor Patrick Chinnery, a Wellcome Senior Fellow in Clinical Science from the Institute of Genetic Medicine at Newcastle University reports that clinics seeing patients with HIV who are being successfully treated with antiretroviral drugs appear to be much older than they really are.

Initially it was quite a mystery, but colleagues have recognized a similar advanced aging process in patients affected by mitochondrial diseases, which are conditions that effect the energy centers in the body's cells.

Chinnery explains that  DNA in our mitochondria gets copied throughout our lifetimes but, as we age, this copying naturally accumulates errors. The researchers believe these HIV drugs accelerate the number of errors happening, so over the course of 10 years, people taking these drugs have the number of errors that would naturally occur in 20 and even 30 years. 

What is surprising, though, is that patients who came off the medication many years ago may still be vulnerable to these changes.

Co-author and HIV specialist, Brendan Payne, M.D., a Medical Research Council fellow from the Department of Infection and Tropical Medicine at the Royal Victoria Infirmary, Newcastle, encourages continued use of these drugs despite the side effects, because the drugs are so important to extending life and finds the risk of aging to berelative.

Payne notes the drugs may not be perfect, but to remember that they are providing people an extra 10 or more years of life when, without these drugs, they would have died.

In Africa, more expensive medications are not feasible, so these older antiretroviral drugs are an absolutely essential. 

In an attempt to understand this aging process on the cellular level, Chinnery and his colleagues studied muscle cells from HIV-infected adults. Some of the patients whose muscle cells were reviewed had previously been given NRTIs and some had not.

The researchers found that the patients who had been treated with NRTIs  had damaged mitochondria, resembling those of a much older person.

This research was published in the journal Nature Genetics.

Reviewed by: 
Review Date: 
June 26, 2011
Last Updated:
July 2, 2011