Silvia Nozza1, Andrea Malagoli2, Lilian Maia3, Andrea Calcagno4, Emanuele Focà5, Giuseppe De Socio6, Stefania Piconi7, Giancarlo Orofino8, Anna Maria Cattelan9, Benedetto Maurizio Celesia10, Elena Gervasi11, Giovanni Guaraldi2. 1. Department of Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy. 2. University of Modena and Reggio Emilia, Department of Mother, Child and Adult Medicine and Surgical Science, Infectious Disease Clinic, Modena, Italy. 3. Department of Infectious Diseases of Centro Hospitalar do Porto, Porto, Portugal. 4. Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy. 5. Department of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy. 6. Department of Infectious Diseases, Azienda Ospedaliero-Universitaria di Perugia, Perugia, Italy. 7. 1st Division of Infectious Diseases Unit, University of Milano, Ospedale L. Sacco, Milano, Italy. 8. Unit of Infectious Diseases, 'Divisione A', Ospedale Amedeo di Savoia, ASLTO2, Torino, Italy. 9. Unit of Infectious Diseases, Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Padova, Padova, Italy. 10. Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, ARNAS Garibaldi, Catania, Italy. 11. 3rd Division of Infectious Diseases, University of Milano, Ospedale L. Sacco, Milano, Italy.
Abstract
Background: GEPPO is a prospective observational multi-centric cohort including HIV-infected geriatric patients. We hypothesized that the GEPPO cohort may help characterize antiretroviral (ARV) prescribing criteria used in real life by Italian infectious disease (ID) physicians. Methods: This was a cross-sectional study describing the current ARV regimen in a geriatric HIV population (≥65 years). Antiretroviral strategies were categorized as follows: (i) multidrug regimens (MDRs), which comprised triple or mega ART combinations; (ii) less drug regimens (LDRs), which comprised fewer than three ART compounds. Multi-morbidity (MM) was defined as the presence of three or more non-communicable diseases, and polypharmacy (PP) as the use of five or more medications in chronic use. Four alternative combinations (MM+PP+, MM+PP-, MM-PP+, MM-PP-) were used in logistic regression analyses. Results: A total of 1222 HIV-positive patients were included (median age 70 years). Females composed 16% of the cohort. Median duration of HIV infection was 17 years; 335 population members had been infected for >20 years. MM was present in 64% and PP in 37% of the patients. Treatment consisted of triple therapy in 66.4%, dual therapy in 25.3%, monotherapy in 6.5% and 'mega-ART' with more than three drugs in 1.64% of the patients. In multivariate logistic regression MM and PP were predictive for mono-dual, NRTI-sparing and tenofovir disoproxil fumarate (TDF)-sparing combinations. Female gender and age were predictors of unboosted ARV regimens. Conclusions: High prevalence of non-conventional ARV regimens in elderly HIV patients suggests that clinicians try to tailor ARV regimens according to age, HIV duration, MM and PP.
Background: GEPPO is a prospective observational multi-centric cohort including HIV-infected geriatric patients. We hypothesized that the GEPPO cohort may help characterize antiretroviral (ARV) prescribing criteria used in real life by Italian infectious disease (ID) physicians. Methods: This was a cross-sectional study describing the current ARV regimen in a geriatric HIV population (≥65 years). Antiretroviral strategies were categorized as follows: (i) multidrug regimens (MDRs), which comprised triple or mega ART combinations; (ii) less drug regimens (LDRs), which comprised fewer than three ART compounds. Multi-morbidity (MM) was defined as the presence of three or more non-communicable diseases, and polypharmacy (PP) as the use of five or more medications in chronic use. Four alternative combinations (MM+PP+, MM+PP-, MM-PP+, MM-PP-) were used in logistic regression analyses. Results: A total of 1222 HIV-positive patients were included (median age 70 years). Females composed 16% of the cohort. Median duration of HIV infection was 17 years; 335 population members had been infected for >20 years. MM was present in 64% and PP in 37% of the patients. Treatment consisted of triple therapy in 66.4%, dual therapy in 25.3%, monotherapy in 6.5% and 'mega-ART' with more than three drugs in 1.64% of the patients. In multivariate logistic regression MM and PP were predictive for mono-dual, NRTI-sparing and tenofovir disoproxil fumarate (TDF)-sparing combinations. Female gender and age were predictors of unboosted ARV regimens. Conclusions: High prevalence of non-conventional ARV regimens in elderly HIV patients suggests that clinicians try to tailor ARV regimens according to age, HIV duration, MM and PP.
Authors: Christina K Psomas; Donald R Hoover; Qiuhu Shi; Todd T Brown; David E Vance; Susan Holman; Michael W Plankey; Phyllis C Tien; Kathleen M Weber; Michelle Floris-Moore; Hector H Bolivar; Elizabeth T Golub; Marcia McDonnell Holstad; Kendra K Radtke; Bani Tamraz; Kristine M Erlandson; Leah H Rubin; Anjali Sharma Journal: J Acquir Immune Defic Syndr Date: 2022-07-01 Impact factor: 3.771
Authors: Emanuele Focà; Paola Magro; Giovanni Guaraldi; Agostino Riva; Anna Maria Cattelan; Giuseppe Vittorio De Socio; Cecilia Costa; Stefania Piconi; Benedetto Maurizio Celesia; Silvia Nozza; Giancarlo Orofino; Antonella Castagna; Giovanni Di Perri; Francesco Castelli; Andrea Calcagno Journal: PLoS One Date: 2019-10-17 Impact factor: 3.240
Authors: R Morillo-Verdugo; M A Robustillo-Cortés; L Abdel-Kader Martín; M Álvarez de Sotomayor Paz; F Lozano de León Naranjo; C V Almeida González Journal: Rev Esp Quimioter Date: 2019-09-17 Impact factor: 1.553