Módulo 1 – Curso pós-graduado – VIH e Envelhecimento

Drug-drug Interactions and Polypharmacy in Older HIV Persons

Polymedication and drug metabolism in aging patients

Autor: Marta Boffito, MD PhD (Chelsea and Westminster Hospital, London, UK)

Comorbidities and polymedication in patients with HIV infection

It has been observed that polypathology is more common in people infected with human immunodeficiency virus (HIV), compared with seronegative individuals, and that increases with increased age.1

In the study of Guaraldi et al., the proportion of individuals aged over 60 years who had comorbidities was higher among those with HIV infection than for the control group (46.9% vs. 18.7%, p<0.001), and 4% of HIV patients had four or more comorbidities vs. 0.25% in HIV-negative individuals.1 The higher number of comorbidities contributes to a higher proportion of polymedicated individuals, assuming polypharmacy as taking five or more drugs. The weight of comorbidities added to the fact that these patients are on three or four antiretrovirals already, contributes even further to polypharmacy.2

Drug exposure increases with age.The inter-individual variability of this exposure also increases with age, due to changes occurring on the absorption, reduced liver function and reduced glomerular filtration rate. These changes may result in a greater drug toxicity or reduced efficacy of antiretrovirals and other medications.

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