AIDS care · 2025
Aging with HIV: multimorbidity and polypharmacy burden.
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Demirbas Nazife Duygu, Diktas Husrev, Gul Ozlem, Derin Okan, Ozgur Umut, Aksu Saliha Busra, Atasoy Tahtasakal Ceren, Oncul Ahsen, Yildiz Sevgi Dilek, Dokmetas Ilyas
Аннотация
BACKGROUND: Aging people living with HIV (PLWH) are at higher risk of multimorbidity and polypharmacy, complicating care.
OBJECTIVE: To assess the prevalence and risk factors of multimorbidity and polypharmacy in elderly PLWH on antiretroviral therapy (ART).
METHOD: 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.
RESULTS: 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).
CONCLUSION: 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.
OBJECTIVE: To assess the prevalence and risk factors of multimorbidity and polypharmacy in elderly PLWH on antiretroviral therapy (ART).
METHOD: 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.
RESULTS: 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).
CONCLUSION: 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.