Romanee Chaiwarith

Young adults with HIV (YA-WH) face aging challenges. The combined impact of HIV, antiretroviral therapy, genetics, lifestyle behaviors, and metabolic factors affects their entire body. This session covers bone health, neurologic function, cardiovascular disease, and strategies for early detection of HIV in children.

Dr. Ferrand presented results from the VITALITY trial in Southern Africa, which assessed the impact of weekly high-dose vitamin D3 (20,000 IU) and daily calcium carbonate (500 mg) supplementation on bone density in adolescents (11-19 years) with perinatally-acquired HIV. While no overall effect on bone density was observed, those with vitamin D insufficiency showed improved bone health. Dr. Frndak examined the effects of HIV and food insecurity (FI) on neurocognitive trajectories in young African adults (15-26 years). YA-WH performed worse in processing speed over time compared to those without HIV. In addition, individuals with FI showed poorer performance in processing speed. Dr. Aurpibul studied three cardiovascular biomarkers (hs-CRP, sCD-163, IL-18) in young adults (18-25 years) with perinatally-acquired HIV in Thailand. Those with viral non-suppression had increased hs-CRP, indicating ongoing inflammation and disease progression. Dr. Mwangwa reported a 24.8% prevalence of unhealthy alcohol use among adolescents and young adults (AYA) (15-24 years) in Uganda and Kenya, associated with a 2.8 times higher risk of viral non-suppression. Silere-Maqetseba implemented universal HIV testing for children at 18 months in South Africa, leading to a 48% increase in annual testing from 2018 to 2023, with testing rates rising from 32% to 45%.

YA-WH, particularly with perinatally acquired HIV, face a heightened risk of long-term health complications. Prolonged antiretroviral therapy, persistent immune activation, and factors like unhealthy alcohol use contribute to issues in bone, cardiovascular, and neurological health. Vitamin D and calcium supplementation improve bone density in those with vitamin D insufficiency. Preventing food insecurity and understanding the predictive value of cardiovascular biomarkers are crucial areas for future investigation for neurocognitive decline and cardiovascular outcome. Early HIV testing in children and a multidisciplinary approach involving parents are essential for effective management and prevention of HIV-related health challenges in this population.