Addressing Long COVID Challenges in People Living With HIV

People living with HIV face challenges connected to managing long COVID that populations not living with HIV may not, including overlapping symptomatology and reduced rates of both recognition that they have this comorbidity and it being diagnosed. To reduce these care disparities and prevent them from exacerbating, education and user-friendly diagnostic methods are key.

Kellie L. Hawkins, MD, assistant professor of medicine, University of Colorado, and attending infectious disease physician, Denver Health, presented findings on patients with these overlapping conditions in the poster “HIV Infection and Long COVID: A RECOVER Program, Electronic Health Record Based Cohort,” at the 2025 Conference on Retroviruses and Opportunistic Infections.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

How does the increased incidence of long COVID in people living with HIV inform clinical guidelines for diagnosing and managing long COVID in patients with preexisting chronic conditions?

I think what it really highlights is that when we approach people who we are concerned that they might have long COVID, or they're concerned they might have long COVID, to really think about if the symptoms were present before their initial COVID[-19] diagnosis—because we know that long COVID symptoms develop 30 days or more after an initial infection—and to keep that in mind. That's really important when we're thinking about managing how can we harmonize these different diagnoses and come up with a treatment plan that takes into account everything they might be experiencing, whether it's from long COVID or a chronic condition.

What strategies can be implemented to improve the recognition and diagnosis of long COVID in people living with HIV?

Diagnosing COVID[-19], particularly long COVID, is a huge challenge that we face in the field, and coming up with a user-friendly way that clinicians can use rapidly to diagnose is going to be very important. But until that time, increasing education around long COVID; many providers don't feel comfortable with their knowledge base around long COVID and therefore wouldn't feel comfortable diagnosing and treating long COVID. That education piece is really important, and that goes for patients, too; letting patients know what to look for when they're thinking they might have long COVID and where they can access care.