CROI 2025: Metabolic and Other Complications of HIV Infection.

Aging-related comorbid conditions have major effects on health, quality of life, and survival in people with HIV (PWH). The 2025 Conference on Retroviruses and Opportunistic Infections (CROI) featured numerous studies about comorbid diseases in PWH. Cardiovascular diseases, including atherosclerosis and heart failure were important topics at the CROI, with ancillary analyses from REPRIEVE (the Randomized Trial to Prevent Vascular Events in HIV) and studies from lower- and middle-income countries. Numerous studies examined epigenetic markers of biologic aging in PWH and the effects of treatments, including glucagon-like peptide-1 receptor agonists. In a clinical trial, cytomegalovirus suppression was shown to decrease immune activation and systemic inflammation, as well as improve physical function. Large epidemiologic studies examining the effect of switching to integrase strand transfer inhibitors showed an increased risk of diabetes and hypertension, which was independent of weight gain. This review focuses on the abstracts presented at CROI 2025 in these areas, highlighting those with the most clinical impact.