Mosaic chromosomal alterations are suppressed in older adults with HIV.

Somatic gene mutations (SGMs) that drive clonal haematopoiesis (CH) have been shown to be more prevalent in people with HIV (PWH), potentially contributing to the higher risk of comorbidities in PWH compared to those without HIV. It is unknown whether mosaic chromosomal alterations (mCA), another form of CH, are associated with HIV. We demonstrate, for the first time, a markedly lower prevalence of mosaic chromosomal alterations (mCA), particularly loss of chromosome Y, in PWH compared to participants without HIV - an opposing pattern to SGMs. Our findings that mCA development may be suppressed in HIV infection suggest that the selective pressures driving mCA-related CH differ fundamentally from those driving SGM-related CH.