As the National Institutes of Health ramps up efforts to tackle the HIV epidemic, Anthony S. Fauci, MD, longtime director of the National Institute of Allergy and Infectious Diseases, is calling for a refined focus on the needs of the more than 1 million Americans living with the virus.

In a letter he and his colleagues published in the Journal of the American Medical Association, Fauci noted that people with HIV who have an undetectable viral load thanks to antiretroviral treatment “have a near-normal life expectancy, and with effective sustained viral suppression, do not transmit HIV to a sexual partner.”

However, HIV-positive individuals still face an array of increased health risks, especially as they age. These include a higher risk for cardiovascular disease and kidney disease, reduced bone mineral density and osteoporosis, liver disease, certain cancers and neurocognitive impairment.

Fauci and his colleagues look forward to the results of the ongoing REPRIEVE trial, which is seeking to determine whether prescribing a cholesterol-lowering statin reduces HIV-positive people’s risk for cardiovascular disease and various other health problems.

Coinfection with the hepatitis B and C viruses is also much more common among people with HIV than among the general population. The essay’s authors called for greater access to hep C treatment.

More research is needed to better understand what drives the myriad health problems people with HIV face, in particular the virus’s association with chronic inflammation, which may be at the root of many age-related health problems.