Takeaways from CROI 2021

The 2021 Conference on Retroviruses and Opportunistic Infections (CROI Conference) took place from March 6th-10th, 2021 and was held virtually due to the COVID-19 pandemic. This article summarized the key research presented at this year’s conference. While much of this research has yet to be published in peer-reviewed journals, the findings do reflect current trends and priorities.

 One study may provide additional evidence that people living with HIV are more likely to experience co-occurring conditions (i.e. multimorbidity) as well as take a larger number of prescribed medications (i.e. polypharmacy) compared to people not living with HIV. While the authors note how these findings did not account for potential key factors such as obesity, the mean age of participants in this study was 52 years old. As a result, multimorbidity and polypharmacy appear to be issues that people with HIV must begin to pay attention to at younger ages.

Additionally, data from the MACS/WIHS (Multicenter AIDS Cohort Study/Women’s Interagency HIV Study) Combined Cohort Study (MWCCS) demonstrated that women living with HIV may have a slightly higher number of comorbidities compared to men, highlighting the need to continue examining how experiences with HIV differ by gender. In contrast, some studies’ results had less clear implications. For example, one study found that people living with HIV were more likely to be at higher risk for heart disease compared to those without HIV, even when issues with high blood pressure were well managed. While this reflects how people living with HIV should be vigilant about heart health, how to address higher risks of heart disease aside from blood pressure management is less clear. Another study indicated that the medication alendronate (also commonly known as Binosto or Fosamax) may help with bone density loss but it was less so how long of a regimen is best. If these are issues that impact you, it is always a good idea to discuss with your doctor and stay up to date on new study results together.

Research on risk factors for COVID-19 as well as its lingering side effects (i.e., “long COVID”) were also popular topics that impact people aging with HIV. Researchers used the data from US National COVID Cohort Collaborative to provide further evidence that not only are people living with HIV more vulnerable to hospitalization due to COVID-19, but these odds increase when someone living with HIV is also an organ transplant recipient, has a history of heart disease, vascular disease, pulmonary disease, or liver disease. An additional study found that people living with HIV that also have a history of frailty are particularly vulnerable to poor outcomes such as long COVID. People aging with HIV who have these comorbidities may especially want to consider a COVID-19 booster shot if they qualify and or continuing to take precautions to avoid COVID-19 infection.

As the population of people with HIV continues to age- one study presented at CROI 2021 estimated that the median age of ART users in the United States is expected to increase from 50 years in 2020 to 53 years in 2030, with more than 25% becoming 65 years old and older- we must continue to pay more attention to aging issues. This is especially the case when it comes to people of color, women, and or LGBTQ people who are aging with HIV.

Source: Sarkar, S., & Brown, T. T. (2021). CROI 2021: Metabolic and Other Complications of HIV Infection or COVID-19. Topics in antiviral medicine, 29(2), 328–333.