AIDS Drugs Can Cause Premature Aging: Study

A class of AIDS drugs has been linked with mitochondrial DNA mutations, which could help explain the premature aging and age-related illnesses seen in some HIV patients, British researchers say in a new study. The implicated class, nucleoside analog reverse-transcriptase inhibitors (NRTIs), represented a great advance in treatment in the late 1980s.

In the study, researchers analyzed muscle cells from HIV-positive adults, including some previously treated with NRTIs. Patients who had taken NRTIs, even those who took them as long as 10 years ago, had damaged mitochondrial DNA much like that of a healthy older person.

"It takes time for these side effects to become apparent, so there is a question mark about the future and whether or not the newer drugs will cause this problem," said study leader Patrick Chinnery of the Institute of Genetic Medicine at Newcastle University. "They are probably less likely to, but we don't know because we haven't had time to see."

NRTIs became less frequently used among patients in wealthier countries due to toxicity concerns. However, generic NRTIs still are commonly dispensed to patients in developing countries who may have little access to newer drugs.

"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," said study co-author Brendan Payne of the Royal Victoria Infirmary in Newcastle. "In Africa, where the HIV epidemic has hit hardest and where more expensive medications are not an option, they are an absolute necessity."

The researchers are exploring ways to repair the damage or curb mitochondrial disease, and they believe exercise is a promising area on which to focus.

The full report, "Mitochondrial Aging Is Accelerated by Antiretroviral Therapy Through the Clonal Expansion of mtDNA Mutations," was published online ahead of the print edition of Nature Genetics (2011;doi:10.1038/ng.863).

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