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Polypharmacy among HIV infected people aged 50 years or older
Sonia Fernández Cañabate1, Luis Ortega Valín1
1Complejo Asistencial Universitario de León, Servicio de Farmacia, León, España.
Insights
Polypharmacy is common in older adults with HIV, affecting over 40% of patients. This increases the risk of drug interactions and highlights the need for careful medication management in this growing population.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Clinical Pharmacology
Background:
- Highly Active Antiretroviral Therapy (HAART) has transformed HIV into a chronic condition, increasing life expectancy.
- This longevity leads to a higher prevalence of comorbidities and polypharmacy in HIV-infected individuals.
- Managing multiple medications in aging HIV patients presents significant clinical challenges.
Purpose of the Study:
- To assess the prevalence of polypharmacy in HIV-positive patients aged 50 and older.
- To identify clinically significant drug interactions in this patient group.
- To describe comorbidities and adherence to HAART among older HIV patients.
Main Methods:
- An observational, cross-sectional study included 154 ambulatory HIV-positive patients aged 50 years or older on HAART.
- Data collected included age, sex, viral load, CD4 count, comorbidities, antiretroviral drugs, concomitant medications, and adherence.
- Patients not providing informed consent were excluded from the analysis.
Main Results:
- Polypharmacy (≥5 medications including HAART) was present in 40.3% of the study population.
- Concomitant medications were used by 73.4%, with common classes including lipid-lowering agents, anxiolytics/sedatives, proton-pump inhibitors, and antihypertensives.
- 102 clinically relevant drug interactions were recorded, with significant associations found between polypharmacy and drug classes (p < 0.001).
Conclusions:
- The prevalence of polypharmacy is high among HIV-positive individuals aged 50 and above.
- Observed comorbidities and drug interactions align with existing literature for this demographic.
- Prioritizing management of drug interactions and addressing age-related comorbidities is crucial for optimal patient care.
Introduction:
Although HAART cannot eradicate HIV, it suppresses viral replication, resulting in a progressive reduction in HIV-related morbidity and mortality. The increase in life expectancy for HIV-infected patients has turned this disease into a chronic disease and, therefore, to the appearance of comorbidities. At the same time there is an increase in the use of concomitant medication, making HIV-infected patient a polymedicated patient.
Objective:
To determine the degree of polypharmacy and to describe clinically relevant drug interactions, as well as the comorbidities and adherence to HAART in HIV + patients over 50 years.
Methods:
Observational, transversal study. Patients ≥50 years on HAART ambulatory were included. The variables were collected: aged, sex, VL, CD4, comorbidities, ARV, concomitant medication, herbal products and adherence. Patients who did not sign informed consent were excluded.
Results:
Were included 154 patients ≥50 years on HAART. The presence of polypharmacy, defined as the use of 5 or more medications including HAART, was 40.3%. 73.4% of the patients had concomitant medication: lipid-lowering agents (33.8%), anxiolytics / sedatives (28.6%), proton-pump inhibitors (26.0%) antihypertensive agents (23.4%). 102 relevant interactions were recorded, finding statistically significant differences in relation to the presence of polypharmacy and pharmacologic drugs classes (p <0.001).
Conclusion:
The prevalence of polypharmacy among HIV+ patients ≥50 years is high. Comorbidities, interactions and drugs associated were similar to those described in the literature. It is necessary to establish priorities in relation to drug interactions with polypharmacy and a correct approach to the pathologies that may develop.
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