Scientists studying the long-term effects of HIV are finding encouraging evidence that modern HIV treatment may help slow, and partially reverse, biological aging associated with the virus. During our recent webinar, “Rewinding the Epigenetic Clock in HIV,” researcher Berta Rodés presented findings showing that effective antiretroviral therapy (ART) can reduce accelerated biological aging, while emerging treatments such as semaglutide and metformin may offer additional benefits.
HIV and Accelerated Aging
As HIV treatment extends life expectancy, the number of older adults living with HIV continues to grow. However, people with HIV often develop age-related conditions such as cardiovascular disease and frailty earlier than people without HIV. Researchers use “epigenetic clocks” to estimate biological age by analysing DNA methylation patterns. Studies show that untreated HIV accelerates epigenetic aging, with this process beginning soon after infection.
ART Partially Reverses Aging
Studies of people starting ART show that suppressing viral replication significantly reduces epigenetic age acceleration, bringing biological age closer to that of HIV-negative individuals. However, the effect is incomplete. “Antiretroviral therapy partially reverses epigenetic aging, but does not fully restore biological age to that of uninfected populations,” Berta Rodés explained.
Researchers are investigating whether treatments targeting aging-related pathways could provide additional benefits. Small studies of metformin have shown promising trends, while studies of semaglutide have reported reductions in several biological aging markers, alongside improvements in liver fat and physical function in people with HIV and fatty liver disease. Early findings also suggest that pitavastatin may help stabilise the pace of biological aging, although larger studies are needed.
Looking Ahead
Researchers caution that epigenetic clocks are currently more useful for population-level research than for predicting an individual’s health or lifespan. Overall, the findings suggest that HIV treatment may do more than control the virus: it may also reverse part of the biological aging associated with chronic infection. Future therapies targeting inflammation, metabolism and cellular aging could help further improve long-term health for people living with HIV.
