HIV Roundtable: Examining Aging with HIV, Multidrug Resistance, and Vaccine Development

EP: 1.HIV Roundtable: Managing medications after diagnosis

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EP: 2.HIV Roundtable: Examining Aging with HIV, Multidrug Resistance, and Vaccine Development

EP: 3.HIV Roundtable: Adolescents and Issues Around Care, Adherence, and Privacy

This is the second episode of our 3-part series on HIV care and management. This is a continuing collaboration working with our partners Contemporary Pediatrics and Contemporary OB/GYN.

This series discusses several aspects of HIV care including clinical management, therapies, vaccines, and multidrug resistance.

Our panel of clinicians includes:

• MJ Kasten, MD, associate professor of Medicine, consultant, Division of Public Health, Infectious Diseases, and Occupational Medicine, Department of Internal Medicine, Mayo Clinic
• Natasha Hoyte, MPH, CPNP-PC, New York-Presbyterian School Based Health Centers
• Aimalohi Ahonkhai, MD, MPH, associate physician, medicine at the Massachusetts General Hospital, associate director of the Bio-behavioral and Community Science Core and director of the Community Engaged Research Program for the Harvard University Center for AIDS Research
• Jessica Castilho, MD, associate professor of Medicine, Division of Infectious Diseases, associate professor Dept. of Health Policy, Vanderbilt University Medical Center

In this episode, the panel provides clinical feedback on HIV and aging, multidrug resistant HIV, and vaccines.

Castilho says for those patients who are older and who have managed HIV as a chronic condition for years can often be at a higher risk of aging comorbidities.

“We've already heard that HIV treatment has become a lot easier, but the health concerns of older adults living with HIV are increasingly complex, not necessarily because of management of their HIV, but because of the excess and often earlier onset of these comorbidities that many people with HIV experience,” Castilho said. “They are at higher risk for conditions like high blood pressure or diabetes, heart disease, certain cancers and other conditions which really affect their daily quality of life and physical function. So, many times the health concerns that we're encountering and patients are managing on a daily basis are not HIV, but are these chronic comorbidities, and their subsequent conditions like polypharmacy or needing to navigate taking multiple medications.”

With regards to an HIV vaccine, the clinicians acknowledge the complexity of developing a vaccine for the virus, but acknowledge another virus that was helped in the process.

“Using COVID as an analogy is helpful because we all experienced viral evolution and understanding how certain parts of a virus can change over time that we needed different vaccines to manage the COVID pandemic and HIV…so it makes it inordinately challenging to find a vaccine,” Ahonkhai said.

“The virus itself is very smart and very tricky, and makes this challenging. A lot of mRNA research that led to the COVID vaccine being developed had come out of the HIV field. So, we have HIV to thank even though we don't have a vaccine for HIV just yet…but I think we're all hopeful that we can get there.”

Stay tuned for final episode which will appear next week.