New research shows that antiretroviral therapy can reduce HIV-related accelerated biological aging by nearly 4 years, highlighting the critical importance of early and sustained treatment.
A landmark study presented at ESCMID Global 2026 has revealed that antiretroviral therapy (ART) can significantly reverse accelerated biological ageing in people with HIV, reducing it by nearly four years and offering new insight into long-term health outcomes.
Using a novel plasma proteomic aging clock (PAC), researchers were able to measure biological age based on patterns in hundreds of blood proteins, providing a more precise picture of physiological ageing than chronological age alone. The model was developed using samples from the Swiss HIV Cohort Study and applied to individuals both before and after initiating ART.
Findings showed that untreated HIV infection accelerates biological ageing by a median of 10 years. However, after just over a year and a half of ART, participants experienced a statistically significant reduction of 3.7 years in biological age. Continued treatment was associated with further alignment between biological and chronological aging, suggesting ongoing recovery.
The study also highlights that this reversal is not solely tied to traditional immune markers like T-cell recovery, but rather reflects broader improvements in inflammatory and immune system function. These findings reinforce the growing understanding that untreated HIV drives systemic aging processes, increasing the risk of age-related diseases such as cardiovascular conditions.
Antiretroviral therapy reduced HIV-related accelerated biological aging by approximately 3.7 years.
Untreated HIV infection can accelerate biological aging by as much as 10 years.
Early initiation and consistent adherence to ART are critical for slowing and potentially reversing aging-related effects of HIV.
“This research demonstrates the importance of early start and optimal adherence to ART,” said lead author Barry Ryan, PhD. “We’re extremely fortunate to have a unique group…With this group, we have measured the effect of untreated HIV infection and successful ART on telomere shortening, epigenetic ageing and now proteomic aging.”
Importantly, the data showed that accelerated aging begins early in infection, even near the time of diagnosis, further emphasizing the need for prompt intervention.
“Our findings support the current consensus for starting ART promptly after HIV diagnosis,” Ryan explained. “Nonetheless, we observed accelerated proteomic aging irrespective of T-cell homeostasis, with acceleration already occurring nearest the time of HIV diagnosis.”
Researchers note that while further validation in diverse populations is needed, the overall trend is clear: untreated HIV accelerates aging, and effective treatment can meaningfully reverse it.
