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. 2021 Sep;22(8):742-749.
doi: 10.1111/hiv.13122. Epub 2021 Jun 2.

Relationship of polypharmacy to HIV RNA suppression in people aged ≥ 50 years living with HIV

M M Murray  1   2 , J Lin  1 , A Buros Stein  3 , M L Wilcox  2 , J Cottreau  4 , M Postelnick  2 , F J Palella  5
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Free article

Relationship of polypharmacy to HIV RNA suppression in people aged ≥ 50 years living with HIV

M M Murray et al. HIV Med. 2021 Sep.
Free article

Abstract

Objectives: People living with HIV (PLWH) aged ≥ 50 years face unique challenges regarding their medication therapies, especially antiretroviral therapy (ART). Use of ARTs, along with medications for comorbidities, may lead to adverse events, drug-drug interactions (DDIs) and poor adherence. The objective of this study was to identify the number of medications above which PLWH aged ≥ 50 years are less likely to be virally suppressed and to describe other associated patient-specific risk factors.

Methods: This was a cross-sectional study of PLWH aged ≥ 50 years, prescribed ART, and seen at least once in the Northwestern Infectious Disease Center between 1 June 2013 and 31 May 2015. Variables concerning medication use and comorbidities were collected. The primary outcome was the presence of an undetectable plasma HIV RNA level (viral load).

Results: Among the 621 included patients, there was a higher percentage taking ≤ 15 medications with an undetectable plasma HIV RNA (n = 453; 80.6%) vs. patients taking > 15 medications (n = 40; 67.8%; P = 0.03). Taking > 15 medications [odds ratio (OR) 0.49; 95% confidence interval (CI) 0.26-0.96], pulmonary disease (OR 0.54; 95% CI 0.3-0.97) and CD4 T-lymphocyte count < 200 cells/μL (OR 0.39; 95% CI 0.22-0.68) decreased the odds of having an undetectable plasma HIV RNA.

Conclusions: PLWH taking > 15 medications were less likely to have an undetectable HIV RNA. Further studies are needed to evaluate the impact of overall medication economic burden on clinical outcomes among PLWH ≥ 50 years of age.

Keywords: HIV; adverse events; aging; multimorbidity; polypharmacy.

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