Jennifer Hoy has over 30 years experience in HIV clinical research and patient care. She is the inaugural Professor Director of HIV Medicine at the Alfred Hospital and Monash University, Melbourne and established the Infectious Diseases Clinical Research Unit at Fairfield Hospital prior to its move to The Alfred Hospital.

Professor Hoy has made significant contributions to the HIV research effort nationally and internationally. She has been Principal Investigator (PI) for over 200 clinical studies at the Alfred Hospital (Fairfeld Hospital) and has collaborated widely on investigator-initiated pathogenesis studies. Her main research interest is in the evaluation of the causes of co-morbidity and mortality in people living with HIV infection and the effect of Antiretroviral Therapy. Her current research interests include the comorbidities associated with Aging and HIV, in particular bone disease and cardiovascular disease, and the impact of residual immune activation and chronic inflammation.  Her other passion is ensuring the quality of care provided to PLHIV, and quality of life experienced by PLHIV.

She has mentored over 10 postgraduate students (MPH, PhD, postdoctoral fellows). Her research productivity is evidenced by over 200 peer-reviewed publications, and the editing/authorship of 8 books. She was a member of the Australian Antiretroviral Guidelines Panel for over 10 years, and has been a productive member of the international IAS-USA Antiretroviral Guidelines panel since 2012.

HIV and Bone Disease

People living with HIV (PLHIV) have lower bone mineral density (BMD) and experience more fractures than the general population of similar age.  Both HIV-infection and antiretroviral treatment (ART) for HIV contribute to BMD loss, along with traditional risk factors; the relative contributions of lifestyle factors, HIV and ART are unknown.

The effect of HIV alone and introduction of ART was evaluated in 400 patients in the START study (START BMD substudy) and revealed that initiation of ART results in greater declines in bone mineral density than deferring ART and declines were greatest in the first year of ART. No clinical, HIV-related, or ART characteristics predicted greater BMD loss.

Significant ART-induced bone loss slows after the first year of ART.

It is known that all ART drugs can increase BMD loss in HIV patients, but exposure to tenofovir disoproxil fumarate appears to have a significantly greater effect. In patients with low BMD, it was unknown whether switching tenofovir DF to another ART drug or treatment with a bisphosphonate is the more effective and safe option for increasing bone mineral density. A randomised trial (ZeST study) has now demonstrated that treatment with zoledronic acid was superior to switching the tenofovir DF.

Stored samples are available from these studies to further understand the role of ART in loss of bone.

HIV and Cardiovascular Diseases

Cardiovascular disease is one of the major causes of morbidity and mortality in people living with HIV, with a 2-fold increased risk when compared with the general population.

This elevated risk is likely due to a complex interplay between the increased incidence of traditional cardiac risk factors, the adverse effects of ART and the pro-inflammatory effects of HIV itself.

A number of projects are being undertaken to better understand the contributions of lipid abnormalities, chronic inflammation and platelet function in the observed increased risk of atherosclerosis and clinical CVD events.

Access to the Victorian HIV Service database which contains clinical and treatment characteristics of people who received HIV care through Fairfield Hospital/Alfred Hospital and a plasma sample repository (Victorian HIV Blood and Tissue Storage Bank) following Research and Ethics approval, underpins the research into HIV and comorbidities.

Director of HIV Medicine, The Alfred

Prof Hoy has over 30 years’ experience in HIV clinical research and patient care, and established the Clinical Research Unit at The Alfred. Prior to this, she established and directed the Infectious Diseases Clinical Research Unit from 1988-2008, building it into an internationally recognized research program.

She has been Principal Investigator for over 175 clinical studies at The Alfred and has collaborated widely on investigator-initiated pathogenesis studies.

1997             Rescriptor Focus Group (Pharmacia and Upjohn, Sydney

1997             Roche HIV Advisory Board, Sydney

2004-2007     Roche Enfuvirtide Advisory Board

2001-2023     Gilead Advisory Board

2002-2007     Bristol Myers Squibb Advisory Board

2004-2007     Boehringer-Ingelheim HIV Panel Discussion Group

2005-2006     Abbott Kaletra Advisory Board

2005-2018     Merck Sharp & Dohme Advisory Board

2005-2013     Janssen-Cilag Australia HIV Advisory Board

2006-2007     Pfizer Maraviroc Advisory Board

2007-2017     International Gilead Advisory Board

2009-2023      ViiV Advisory Board

2017-2018     ViiV Global D3 Advisory Board

Community Teaching

• Education and Resource Centre, The Alfred Hospital 2008-2017
• When to Start ART, 2016
• National Association of People Living with HIV/AIDS 2009-2013
• Basic Science of HIV presentation – NAPWHA – March 2013
• Victorian HIV Service Now and in the Future – 2015 presentations to Victorian AIDS Council Board, and Living Positive Board
• Pheonix program – Living Positive Victoria, Straight Arrows and Poz Women 2016-2023
• HIV and Ageing – THH and Living Positive Victoria 2020-22