CIAIC Seminar 2024-11-18 Kalen Petersen

Most persons with HIV (PWH) in the United States are older than 50 years. Aging in this population is complicated by direct effects of viral infection, prevalent comorbidities, and adverse social determinants of health. Approximately 1in 3 PWH experience some degree of HIV-associated cognitive impairment, leading to the hypothesis that aging-related changes in brain structure and function are accelerated in this population. Multimodal magnetic resonance imaging provides evidence to support this hypothesis, including neurological changes to gray matter, white matter, and cerebral blood flow. Epigenetic studies provide further evidence for accelerated aging at the cellular level. Persons with well-controlled HIV show greater biological age according to multiple DNA methylation-based clocks. Epigenetic age acceleration also corresponds to both brain phenotypes and cognitive impairment across several domains. Future work will investigate whether MRI and epigenetics can jointly improve prognosis for cognitiveimpairment, allowing earlier, more effective clinical interventions targeting modifiable risk factors.