The increasing use of GLP-1 receptor agonists, a class of drugs initially developed for type 2 diabetes, is prompting a reassessment of potential interactions with HIV treatment regimens, according to research presented at the Conference on Retroviruses and Infectious Diseases (CROI) in 2026. Todd T. Brown, MD, PhD, a clinical investigator at Johns Hopkins Medicine, highlighted the need for careful evaluation as oral formulations of these drugs become more widely available.
Dr. Brown’s work focuses on metabolic, endocrine, and skeletal abnormalities in people living with HIV, particularly as they relate to aging. His research examines the pathogenesis of glucose disorders, fat changes, and hormonal dysregulation within this population. He leads the Clinical Translation Core at the Claude D. Pepper Older Americans Independence Center, where he investigates the interplay between these factors and HIV infection.
The forthcoming availability of small-molecule, oral GLP-1 receptor agonists is a key driver of this renewed scrutiny. Currently, GLP-1 receptor agonists are primarily administered via injection. The shift to oral administration, even as offering increased convenience, necessitates a deeper understanding of their metabolic pathways and potential for drug interactions. Specifically, concerns have been raised regarding possible interactions with protease inhibitors, a common component of HIV treatment.
Dr. Brown’s presentation at CROI 2026, titled “GLP-1 Receptor Agonists: Are They a Cure for Everything?” explored the broad implications of these drugs, extending beyond their initial metabolic targets. Jeanne Marrazzo, MD, MPH, CEO of the Infectious Diseases Society of America, presented alongside Dr. Brown, addressing the concurrent surge in sexually transmitted infections, though the specific connection to GLP-1 agonists was not detailed in available reports.
The Todd Brown Lab at Johns Hopkins conducts epidemiologic studies to understand the occurrence and prevalence of insulin resistance, diabetes, and anthropometric changes in HIV patients, and their relationship to antiretroviral treatment. This research utilizes both translational investigation and clinical trials to optimize the evaluation and management of these conditions, and their consequences, such as cardiovascular disease and frailty.
Dr. Brown is a Professor of Medicine at the Johns Hopkins School of Medicine and accepts new patients at the Johns Hopkins Outpatient Center in Baltimore, Maryland. His clinical focus encompasses young adults, adults, and older adults. His work builds on a foundation of training that includes a PhD from Johns Hopkins Bloomberg School of Public Health, a fellowship in Endocrinology and Metabolism at Johns Hopkins University School of Medicine, and a residency at MedStar Georgetown University Hospital.
