HIV-associated comorbidities in the ART era: clinical challenges and translational perspectives

The widespread use of effective antiretroviral therapy (ART) has transformed HIV infection into a chronic condition, significantly improving life expectancy and reducing AIDS-related morbidity. Consequently, the clinical management of people living with HIV (PWH) increasingly involves the prevention, early diagnosis, and treatment of comorbidities that arise independently of the HIV infection itself. Cardiovascular and metabolic diseases, chronic kidney disease, bone disorders, liver diseases, neurocognitive decline, and malignancies pose significant challenges in the current care of patients with HIV. Their onset results from the interplay of traditional risk factors, ART-related effects, coinfections, persistent low-grade inflammation, immune dysregulation, and the aging of the HIV-affected population. However, the growing complexity associated with multimorbidity and polypharmacy necessitates a shift from a single-disease-focused approach to integrated, patient-centered models of care.This Research Topic aims to address the clinical and translational challenges associated with HIV-related comorbidities in the ART era, placing particular emphasis on strategies for prevention, screening, diagnosis, monitoring, and treatment. The onset of comorbidities in PWH is multifactorial, reflecting the interplay between traditional risk factors, the effects of antiretroviral drugs, disparities in access to care, persistent immune activation and inflammation, and age-related changes. Although effective ART substantially reduces HIV-associated morbidity and mortality, it does not eliminate the immune dysregulation and low-grade inflammatory processes that can contribute to the development and progression of various comorbidities. A better understanding of these interconnected mechanisms could help to identify clinically relevant biomarkers and risk factors, improve risk stratification, and enable earlier diagnosis. It could also guide the development of new preventive and therapeutic approaches. Consequently, this Research Topic will highlight recent advances aimed at improving clinical outcomes by identifying comorbidities early, optimizing treatment and prevention strategies, and personalizing the management of PWH who have multiple chronic conditions. Particular attention will be paid to the clinical implications of ART selection and treatment-related adverse effects, lifestyle interventions, and integrated care models, while encouraging translational research that links underlying biological mechanisms to improved clinical management.We welcome Original Research articles, Reviews, Brief Research Reports, Methods, and Perspectives, focusing on the clinical and translational aspects of HIV-associated comorbidities. Topics of interest include, but are not limited to:Screening, risk assessment, and prevention: development and validation of strategies for the early identification of cardiovascular, metabolic, renal, hepatic, bone, neurocognitive, and oncological comorbidities, as well as the identification of high-risk individuals and the evaluation of preventive interventions, including lifestyle modification, physical activity, nutrition, and other evidence-based approaches tailored to PWH.Clinical management and standards of care: evaluation and implementation of HIV-specific approaches for the long-term monitoring and management of comorbidities, including multimorbidity and polypharmacy, and the adaptation of clinical guidelines and standards of care to the needs of PWH across different age groups.ART and comorbidities: clinical impact of antiretroviral therapy and treatment choice on the risk, prevention, and management of metabolic and organ-related comorbidities, including treatment-related adverse effects.Biomarkers and patient-reported outcomes: identification and validation of clinical, laboratory, and patient-reported parameters to improve risk stratification, early diagnosis, monitoring, and management of comorbidities.Clinical outcomes in diverse populations: analysis of differences in comorbidity burden, prevention, diagnosis, and management across diverse populations and healthcare settings, including resource-limited environments.Please note that manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by robust and relevant validation (clinical cohort or biological validation in vitro or in vivo) are out of scope for this Research Topic. Manuscripts focusing solely on cost-effectiveness studies are also not considered for publication in this journal. Topic editors: Sonia Moretti, Daniel Scott-Algara Source: https://www.frontiersin.org/research-topics/84702/hiv-associated-comorbidities-in-the-art-era-clinical-challenges-and-translational-perspectives