by Jeffrey T. Kirchner, DO, AAHIVS, AAHIVM Chief Medical Officer

December 29, 2020

Featured Literature:

Pahwa S, Deeks S, Zou S et al. NIH Workshop on HIV-Associated Comorbidities, Coinfections, and Complications: Summary and Recommendation for Future Research. J Acquir Immune Defic Syndr. 2021 Jan 1;86(1):11-18. doi: 10.1097/QAI.0000000000002528.

Due to the effectiveness of antiretroviral therapy (ART) most persons with HIV (PWH) are achieving normal lifespans but not normal or healthy aging. A higher-than-expected rate of coinfections, comorbidities and complications (CCC) which are worsened by stigma, poverty, and isolation have been found in PWH. To address the research needs for HIV-associated CCC, the NIH brought together 96 medical experts and community advocates. From this group of individuals, five working groups (WG) participated in a year-long process of assessing the “state of the art” regarding numerous aspects of HIV care. It was the responsibility of the WGs to select 3 to 5 priority topics for presentation and discussion. The NIH then held a 2-day CCC workshop (HIV ACTION) that included over 400 participants. The format included general and individual WG presentations and discussions. Priority lists of vital research issues were presented by the co-chairs of each WG. The NIH planning committee identified six key areas of research: epidemiology and population including aging with HIV; pathogenesis and basic science that includes immunopathogenesis; clinical research that includes comorbidity management; implementation science; syndemics research including HIV-infectious syndemics; and international research in low- and middle-income countries that consist of research needs and curricular training in HIV/AIDS comorbidities. Going forward, the participants in the HIV workshop emphasized the need for “collaborative efforts of many disciplines” to implement this ambitious research agenda needed to improve the health and wellbeing for persons with HIV.

Author’s Commentary:

As this is my last Clinical Research Update for the Academy, I thought it was appropriate to highlight this article. Even though the workshop convened over one year ago this paper will be published in the January 2021 issue of AIDS. Despite the remarkable effectiveness of ART over the past 20 years, there is still a great deal regarding chronic HIV infection that we do not know. Until there is a cure or an effective vaccine, there remains significant work that must be done by the HIV research and clinical care communities and should include issues relevant to PWH in the developed and developing world. This article from JAIDS contains the streamlined list and a summary of WG discussions to inform investigators of current research priorities in the field of HIV medicine. View the full detailed report from the 2-day NIH workshop here.

The author has no conflicts of interest to disclose.

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