CROI 2025: The Challenges of Sustaining Viral Suppression, Addressing Advanced HIV Disease, and Ending the HIV Epidemic Targets.

Overview

Important new data were presented at the 2025 Conference on Retroviruses and Opportunistic Infections. Mathematic models predicted a reversal of progress toward Ending the HIV Epidemic metrics if funding is discontinued. Interventions that improved HIV care outcomes included a clinic-based, person-centered care intervention and a low-barrier care clinic service delivery model. Several studies demonstrated varying trends in hepatitis B and C incidence and outcomes, and data from one trial showed the seroprotective durability of the adjuvanted hepatitis B vaccine in people with HIV. Focus continued on long-acting antiretroviral therapy (ART) including data on promising new agents and formulations. Integrase strand transfer inhibitors (InSTIs) may be effective in the real world despite baseline reverse transcriptase resistance, although 2 studies highlighted the emergence of mutations outside the integrase genome that contribute to InSTI resistance. The data on HIV and maternal and pediatric health included studies aimed at HIV testing and counseling. It also covered drug interactions between implant and injectable hormonal contraceptives and dolutegravir-based ART, along with selected pharmacokinetics and safety data for ART in infants and children. Various abstracts addressed weight gain and cardiometabolic dysfunction in youth with perinatally acquired HIV and in women with HIV, as well as health outcomes for children exposed to HIV and ART in utero.