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Relationship of polypharmacy to HIV RNA suppression in people aged ≥ 50 years living with HIV
Author(s) -
Murray MM,
Lin J,
Buros Stein A,
Wilcox ML,
Cottreau J,
Postelnick M,
Palella FJ
Publication year - 2021
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.13122
Subject(s) - medicine , polypharmacy , odds ratio , viral load , confidence interval , adverse effect , medical prescription , human immunodeficiency virus (hiv) , disease , pediatrics , immunology , pharmacology
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.