From Weight Gain to Heart Strain: HIV Antiretroviral Adverse Effect Management in Primary Care

More than 40 years after discovering HIV, the prognosis has transformed from an acute, fatal illness, to an average life expectancy approximating that of the general population. Correspondingly, new concerns regarding the management of older adults with HIV and multimorbidity are beginning to emerge. To support the HIV care continuum, people with HIV benefit from having a primary care medical home to address multimorbidity associated with age, genetic disposition, chronic HIV, and/or antiretroviral adverse effects. The interplay between HIV, antiretrovirals, and metabolic conditions is complex and is under study. It is imperative that primary care clinicians and medical team members are aware of how HIV and antiretrovirals can impact a person's comorbidities and corresponding mitigation strategies.

The goal of this commentary is to raise awareness of the metabolic consequences of modern antiretrovirals so that interdisciplinary teams caring for people with HIV can better coordinate the management of related conditions such as obesity, diabetes, and cardiovascular disease.