Aging with HIV: multimorbidity and polypharmacy burden

Aging people living with HIV (PLWH) are at higher risk of multimorbidity and polypharmacy, complicating care.

To assess the prevalence and risk factors of multimorbidity and polypharmacy in elderly PLWH on antiretroviral therapy (ART).

In this cross-sectional study, PLWH aged ≥50 were compared with age- and sex-matched people without HIV. Logistic regression was used to identify predictors of polypharmacy.

Multimorbidity (≥2 chronic conditions) was seen in 29% of PLWH and 22% of controls. Osteoporosis (9.5% vs. 2.3%) and psychiatric disorders (9.5% vs. 2.8%) were significantly more common in PLWH (p < 0.001). Polypharmacy (≥5 non-ART medications) was more frequent in PLWH (20.4% vs. 11.8%, p = 0.014). In multivariable analysis, being in the PLWH group (aOR 2.41), increasing age (aOR per 1-year 1.05), and having no formal education (aOR 4.59) were independent predictors of polypharmacy. Potential drug-drug interactions were present in 19.4% of PLWH and were present in those with polypharmacy (33% vs. 16%, p < 0.001).

Older PLWH experience greater multimorbidity and polypharmacy than people without HIV. Tailored strategies - such as medication review, drug interaction monitoring, and preventive care - are essential to optimize outcomes in this growing and vulnerable population.