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HIV duration of 20 Years in 75 year olds Doubles Multimorbidities & Polypharmacy Rates & This Causes Using HAART with Less Drugs in the Regimen - Silver champions from the GEPPO cohort (GEriatricPatients living with HIV/AIDS):
a case control study of people above 75 years of age addressing Multimorbidity
Polypharmacy and Antiretrovirals' Prescription in old HIV patients.
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Reported by Jules Levin
18th International Workshop on Comorbidities and Adverse Drug Reactions in HIV, September 12-13, 2016, New York
Guaraldi G1, Malagoli A1, Calcagno A2, Mussi C3, Celesia BM4, Carli F1, Piconi S5, De Socio GV6, Cattelan AM7, Orofino G8, Riva A9, Focà E10, Nozza S11, Bugliosi E12, Di Perri G2
from Jules: you can see polypharmacy was used much more often in HIV+ (55% vs 35%) in patients with HIV more than 20 years; multicomorbidity was reported much more often in HIV+ (81% vs 65%) in patients with HIV more than 20 years; chronic kidney disease occurred more often in patients with HIV+ for all HIV groups [<10 yrs; 10-20 yrs; >20 yrs] and was 33% vs 7% in HIV+ for more than 20 years; dyslipidemia as well was 76% in HIV+ for more than 20 years vs 46% in HIV-negatives. Of note, HIV+ because of polypharmacy were prescribed HAART regimens containing less drugs. Twice as many HIV+ received statins.
Program abstract - Results: A total of 492 patients were included (292 HIV+ and 200 HIV-neg, see Table 1). At logistic regression analysis HIV duration above 20 years was an independent predictor of MM - multi morbidity - (OR=2.31) and PP - polypharmacy - (OR=2.36). Less drug regimens (LDR) were used in 101 patients (35.31%) and included dual therapy in 82 (28.67%) and mono therapy in 19 subjects (6.64%). PP was a significant predictor of LDR (aOR=3.08). Tenofovir was used in only 8 patients (2.7%) and NRTI-sparing and booster free regimens in 163 (56.4%) and 127 (59.3%). PP only was associated with LDR regimens.
Cross sectional study comparing HIV+ patients and HIV- individuals referred to a cardiovascular screening clinic in a geriatric Centre. They were age (±4 years) and sex matched.
Multimorbidity (MM) was classified as the presence of 3 or more of Non Infectious Comorbidities (NICM), Polypharmacy (PP as the use of 5 or more medications (excluding ART). Patients were stratified according to the duration of HIV infection (>20, 10-20 and <10 years).
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