HIV accelerates ageing?

May 24th, 2009

I read an intriguing piece in Le Monde this morning before I’d gone for a walk, gotten lunch, and gotten blood flowing back to my brain, which noted that HIV+ patients how are now living longer thanks to new treatments, are even so ageing faster than the rest of the population, developing conditions of ageing markedly earlier than normal. I will now demonstrate for all the world to say just how badly my French has deteriorated over the last 10 years by translating at least some of it, perhaps all:

It has been lumbered with a rather dumbed-down headline, but what do you expect, Le Monde is mainstream media?

Le sida accélère le vieillissement

AIDS accelerates ageing

Umm, well, no, but nevermind:

Les personnes infectées par le virus du sida (VIH) vieillissent-elles plus vite que les autres ? Différentes études en apportent des preuves, comme l’a illustré un séminaire de recherche clinique de l’Agence nationale de recherche sur le sida et les hépatites virales (ANRS), qui s’est tenu à Paris début mai.

Do people infected with the AIDS virus (HIV) age faster than others? Different studies have shown evidence of this, as a clinical research seminar of the National Agency for AIDS and Viral Hepatitis Research (ANRS) held at the start of May in Paris showed.

L’évolution de cette maladie vers un profil de maladie chronique dans les pays développés s’est accompagnée d’une espérance de vie proche de celle de la population générale pour les personnes efficacement traitées. Cliniciens et chercheurs ont cependant constaté chez des sujets porteurs du VIH l’apparition de pathologies métaboliques, cognitives ou cardio-vasculaires associées au vieillissement à un âge nettement plus précoce que dans la population générale.

The evolution of this disease towards one with the profile of a chronic illness in developed countries has been accompanied with a life expentancy for those treated effectively close to that of the general population. Clinicians and researchers, however, have noted the appearance of metabolic, cognitive or cardio-vascular pathologies associated with ageing among HIV carriers at an age markedly younger than in the general population.

Cette sénescence prématurée est une réalité sur le plan biologique et clinique. “La comorbidité associée au vieillissement (ostéoporose, pathologies neurologiques, diabète, anomalies des lipides, cancers, etc.) apparaît dès 45-50 ans chez les patients VIH +, alors qu’elle touche les sujets de 65 ans et plus dans la population générale”, remarque la professeure Jacqueline Capeau (Inserm UMR 938, université Pierre-et-Marie-Curie, Paris), qui dirige le groupe de travail de l’ANRS sur ce thème.

This premature senescence is a biological and clinical reality. “Comorbidity associated with ageing (osteoporosis, neurological pathologies, diabetes, anomalies with lipids, cancers, etc) appear between 45 and 50 years of age in HIV+ patients, when they affect people over 65 in the general population”, notes professor Jacqueline Capeau (Inserm UMR 938, université Pierre-et-Marie-Curie, Paris), who directs the ANRS’ work group on this subject.

Ce phénomène est observé pour les troubles cognitifs dans les résultats préliminaires d’une étude baptisée CogLoc. “Les résultats concernant les 323 patients déjà inclus, d’un âge médian de 46 ans, montrent qu’une personne séropositive sur cinq présente des déficits légers ou modérés (avec dans ce cas un retentissement sur la vie quotidienne). Ces troubles ne touchent que de 3 % à 5 % de la population générale âgée de plus de 65 ans”, indique la professeure Geneviève Chêne (Inserm U897, Institut de santé publique, d’épidémiologie et de développement, université Victor-Segalen, Bordeaux), responsable de l’étude avec le professeur Patrick Dehail (CHU de Bordeaux).

This phenomenon is observed in cognitive problems in the preliminary results of a study named CogLoc. “The results for the 323 people already included, with a median age of 46, show that one fifth of HIV+ people present light or moderate deficits (affecting, in this case, everyday life). These troubles only affect 3% to 5% of the general population aged over 65”, says Professor Geneviève Chêne (Inserm U897, French Institute for Public Health, Epidemiology and Development, université Victor-Segalen, Bordeaux), responsible for the study with Professor Patrick Dehail (CHU de Bordeaux).

Lancée en 2007 par l’ANRS, l’étude CogLoc évalue la fréquence des troubles cognitifs et locomoteurs chez les patients infectés par le VIH, au sein de la “cohorte Aquitaine”. Les troubles cognitifs apparaissent corrélés à différents facteurs généraux : âge, niveau d’études plus bas, traumatisme crânien dans l’enfance, syndrome dépressif. Mais, ils sont également en relation avec l’avancement de l’infection par le VIH : “Les patients dont la maladie est la plus avancée présentent le plus de troubles cognitifs. Toutes les fonctions cognitives ne sont pas affectées de la même façon. Les capacités verbales et lexicales sont plus touchées que la mémoire”, souligne la professeure Chêne.

Launched in 2007 by the ANRS, the CogLoc study evaluated cognitive and locomotive problems in patients infected with HIV, within the “Aquitaine cohort”. Cognitive problems seem to be associated with different general factors: age, lower level of education, childhood head injury, depression. But there is equally a relationship with the advancement of HIV infection: “Patients in whom the disease is more advanced present more cognitive problems. All the cognitive functions are affected the same way. Verbal and lexical capacity are more affected than memory,” emphasised Professor Chêne.

Comment expliquer ce phénomène de vieillissement prématuré ? “En plus de l’hygiène de vie et surtout du tabagisme, trois facteurs peuvent jouer : le virus lui-même, le déficit immunitaire et les traitements antirétroviraux”, avance la professeure Capeau.

How to explain this phenomenon of premature ageing? “In addition to hygiene and especially smoking, three factors can be at play here: The virus itself, immune deficiency, and anti-retroviral treatments,” suggests Professor Capeau.

Même lorsque l’infection est bien contrôlée, le virus continue de se répliquer dans différents compartiments du corps appelés “réservoirs”. C’est le cas, notamment dans les macrophages. Très ubiquitaires, ces cellules qui participent aux défenses immunitaires infectent d’autres cellules dans les tissus voisins. L’activation sans relâche du système immunitaire aboutit à son épuisement et à une forme d’“immunosénescence”, explique la professeure Capeau. Enfin, certains antirétroviraux possèdent une toxicité cellulaire susceptible d’entraîner un vieillissement précoce.

Even when the infection is well controlled, the virus continues to replicate in different compartments of the body called reservoirs. It’s especially true in macrophages. Very widely spread, these cells of the immune sysem infect other cells in neighbouring tissues. The relentless activation of the immune system ends in its exhaustion and a form of “immunosenescence”, explains Professor Capeau. Finally, certain anti-retrovirals have a cellular toxicity likely to lead to early ageing.

Un mécanisme possible a été identifié. Il impliquerait une protéine, la lamine A/C, présente dans le noyau des cellules où elle contribue au maintien de la membrane nucléaire. Des mutations du gène de cette protéine sont en cause dans différentes maladies, dont certaines lipodystrophies (anomalies de la répartition des graisses) et la progéria, une forme de vieillissement accéléré.

A possible mechanism has been identified. It implicates a protein, Lamin A/C, presented in the nuclei of cells where it contributes to the maintenance of the nuclear membrane. Some genetic mutations of the gene for this protein lead to different diseases, including certain Lipodystrophies (“abnormal or degenerative conditions of the body’s adipose tissues” (wikipedia)) and Progeria, a form of accelerated ageing.

Reste enfin des conclusions médicales et médico-sociales à tirer du vieillissement prématuré des personnes infectées par le VIH. D’une part, mettre en oeuvre chez elles des explorations spécifiques afin de rechercher les manifestations d’une sénescence précoce. D’autre part, mener une réflexion sur l’éventuelle nécessité de créer des structures spécifiques pour la prise en charge institutionnelle de ces malades, lorsque la question se posera pour eux d’aller en maison de retraite.

There are still medical and medico-social conclusions to be drawn from this premature ageing of people infected with HIV. On the one hand, initiating specific investigations to research the manifestations of an early ageing. On another hand, leading a reflection on the eventual neccisity of creating specific structures for taking these patients into institutional care when the question of entering a retirement home arises for them.

Well, I definitely read French faster than Chinese, even after all these years, but I suspect this translation is no more accurate than anything I’ve translated from Chinese. Help, anyone?

4 Responses to “HIV accelerates ageing?”

  1. Richard Says:

    Very little wrong with this translation IMHO! If you can read and translate at this level there nothing wrong with your French :-)

    If anything a couple of the terminologies are undertranslated: for instance “médico-sociale” has no direct equivalent in everyday English – a combination of health and social care, perhaps “community care” or “primary care” are the closest we have. But France has a whole structure of closely linked health/social care services, especially for older people, known as “services médico-sociaux” for which there is no ready comparison in anglo-saxon societies.

    It’s a fairly technical article in terms of the vocab used, and to be honest I’d think many native French speakers would have problems understanding it.

    A benefit/hazard of learning French at university: Francophones are often surprised when someone so obviously foreign and stumbling as me comes out with a very refined choice of words. For instance I used the word “farouche” (wild/savage) in a conversation the other day, apparently this word is largely only used in pre-20thC literature… d’oh! My French friends found it very amusing.

  2. wangbo Says:

    Thanks, Richard, for the huge vote of confidence. I am actually quite concerned about the decay of my French- it seems I’m maintaining my ability to read, but the other skills are seriously degraded. Not good considering French was my major!

    I think you’ve managed to elucidate why I made the gut decision to just anglicise “médico-sociale”. The sense is pretty clear, but it doesn’t seem to map into the anglophone world.

    Had a similar problem with French on Friday night at a friend’s birthday party. Apart from when the noise level intervened, I could understand the French speakers just fine right up until they strayed into that more slang-infested world one doesn’t encounter in Sartre, Cocteau, Giraudoux and Le Monde. I was told to just watch La Haine, that’d be all the education I’d need, but I’ve done that and it was like trying to understand Dutch- it sounds so much like a language I should understand, but I just can’t get it.

  3. Richard Says:

    I live here and I don’t understand much French slang. Slang falls in 2 camps for me – there’s langage familier (all those replacement words for everyday staff eg. bagnole=voiture, schlinguer=puer, gueule=tete) which are worth knowing and cautiously among friends so you don’t sound too formal all the time, (but don’t use them in front of your bank manager).

    Formal: J’ai travaillé toute la journée sur mon ordinateur. Mon projet de recherche peine à s’avancer. C’est vraiment pénible.

    Friendly: Moi j’ai bossé mon truc de recherche toute la journée sur mon ordi! J’ai pas progressé du tout, c’est la galère quoi!

    Then there’s street slang which is impenetrable because it’s a combination of Maghrebin arab, verlan and teen neologisms. I don’t bother because it’s not particularly useful unless you want to understand French rap or you work with kids.

  4. wangbo Says:

    The last paragraph makes me wonder how much regional variation there would be- in other words, were I to move to France, it would be a good idea for me to learn your first example and its appropriate register, but the value of what you describe in the last paragraph would depend entirely on where I was and what my goals would be.

    That should seem fairly obvious after so many years in China, but the impression I have is that the French equivalent of China’s dialects- essentially local languages- was pretty much wiped out by the Revolutionary imposition of Francien.