COBRA: Co-morbidity in relation to HIV and AIDS

PLWH on combination antiretroviral therapy (cART) are at increased risk of the premature development of age-associated non-communicable comorbidities (AANCC). It has therefore been hypothesised that such individuals, despite effective cART, may be prone to accelerated ageing. By building on the POPPY study in London and the AgehIV study in Amsterdam, the COBRA study provided a detailed, prospective evaluation of AANCC among PLWH suppressed on cART and appropriately chosen and comparable non-infected controls. Unique experimental studies in mice also permitted investigators to differentiate the effects of HIV and cART on metabolic outcomes when applied under controlled conditions. The study findings were reassuring for people living with treated HIV infection. Although there were differences in some age-related neuroimaging and soluble biomarkers of cognitive health between the two groups, there was no evidence that treated HIV is associated with accelerated ageing based on cognitive testing, neuroimaging or ageing biomarkers.The group with treated HIV did not age any faster than those without HIV over the two years - they did not lose their mental abilities more quickly than those without HIV, nor did their brain scans appear to deteriorate more rapidly.Interestingly, the study did find differences in some of these measures when the people living with HIV were compared to a group of blood bank donors from the Dutch general population (the demographic and lifestyle characteristics of this group are likely to be very different from those of people living with HIV) but there were also some differences when this group of blood bank donors was compared to the group of COBRA participants without HIV.