Research Paper Volume 13, Issue 19 pp 22772—22791

Immunological age prediction in HIV-infected, ART-treated individuals

Lesley R. de Armas1, , Suresh Pallikkuth1, , Li Pan1, , Stefano Rinaldi1, , Rajendra Pahwa1, , Savita Pahwa1, ,

  • 1 Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA

Received: April 5, 2021       Accepted: September 29, 2021       Published: October 11, 2021
How to Cite

Copyright: © 2021 de Armas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Anti-retroviral therapy (ART) improves life expectancy in people living with HIV (PWH), but it remains unclear how chronic HIV infection affects normal aging of the immune system. Plasma cell-free protein expression and immune phenotypes were assessed in blood from ART treated PWH (19-77yrs, n = 106) and age-matched, HIV-negative controls (HC, n = 103). Using univariate spearman correlation, we identified 277 and 491 age-associated parameters out of a total 1,357 in HC and PWH, respectively. PWH exhibited shared and distinct age-associated immune profiles compared to HC highlighting the effect of HIV infection on immunological aging. Our analysis resulted in an 8-parameter, plasma-detectable inflammatory index that correlated with chronological age of all study participants but was higher overall in PWH. Additionally, predictive modeling for age in HC participants and age-associated parameters generated a 25-parameter signature, IMAP-25, with 70% and 53% accuracy in HC and PWH, respectively. Applying the IMAP-25 signature to immunological data from PWH revealed accelerated aging in PWH by 5.6 yrs. Overall, our results demonstrate that immune signatures, easily monitored in human blood samples, can be used as an indicator of one’s ‘immunological age’ during ART-treated HIV infection and can be applied to other disease states that affect the immune system.


TN: Naïve T cell; MFI: Mean Fluorescence Intensity; AM: Activated Memory; pTFH: peripheral T follicular helper cells; TCM: Central Memory T cell; TEFF: Effector T cell; TTM: Transitional Memory T cell; TH: T helper cell; UnSw: Unswitched; DN: Double Negative; pTFR: peripheral T follicular regulatory cells; RM: Resting Memory; Sw: Switched; TREG: T regulatory T cells; Lasso: least absolute shrinkage and selection operator.