Gimeno-Gracia Mercedes, Crusells-Canales María José, Javier Armesto-Gómez Francisco, Rabanaque-Hernández María José
HIV Clin Trials. 2015 May-Jun;16(3):117-24. doi: 10.1179/1528433614Z.0000000012. Epub 2015 May 15.
The increasing population of human immunodeficiency virus (HIV)-infected elderly patients results in a higher number of comorbidities and greater incidence of polypharmacy in addition to antiretroviral therapy (ART). The aim of this study is to describe the use of concomitant medication in older HIV-infected patients and to compare it with older general population.
The study included HIV-positive outpatients (>49 years) who received ART in 2011. Co-medication dispensed by pharmacies in that year was collected. Defined daily dose (DDD) for each drug was calculated by patient. A comparison was made between the use of co-medication among men between 50 and 64 years old in general population against the HIV-infected population.
The study was based on 118 patients (77% men), of which 82% took at least one co-medication and 58% at least five. The commonest co-medications used by HIV-positive patients were antibiotics (44%); analgesics (44%); anti-inflammatories (39%); antacids (38%); and psycholeptics (38%). The medicines used for the greatest number of days per HIV-positive patient were those related to the renin-angiotensin system; anti-diabetics; lipid modifying agents; antithrombotics; and calcium channel blockers. In comparison with the general male population, a higher proportion of HIV-infected patients used antibiotics (42 vs 30%, P = 0.018), antiepileptics (16 vs 5%, P = 0.000), psycholeptics (35 vs 17%, P = 0.000) and COPD medications (14 vs 7%, P = 0.008). The duration of antibiotics and psycholeptic use in HIV-infected patients was longer compared to the general population (P < 0.05).
Older HIV-positive patients frequently take a higher number of co-medication, which increases the risk of adverse events, interactions with other medication, and may lead to poorer treatment adherence.
感染人类免疫缺陷病毒（HIV）的老年患者人数不断增加，除抗逆转录病毒疗法（ART）外，其合并症数量更多，多重用药的发生率也更高。本研究的目的是描述老年HIV感染患者合并用药的使用情况，并将其与老年普通人群进行比较。
该研究纳入了2011年接受ART的HIV阳性门诊患者（年龄>49岁）。收集了当年药房配发的合并用药。按患者计算每种药物的限定日剂量（DDD）。对普通人群中50至64岁男性与HIV感染人群的合并用药使用情况进行了比较。
该研究基于118例患者（77%为男性），其中82%至少服用一种合并用药，58%至少服用五种。HIV阳性患者最常用的合并用药是抗生素（44%）；镇痛药（44%）；抗炎药（39%）；抗酸药（38%）；以及抗精神病药（38%）。每位HIV阳性患者使用天数最多的药物是与肾素-血管紧张素系统相关的药物；抗糖尿病药；调脂药；抗血栓药；以及钙通道阻滞剂。与普通男性人群相比，HIV感染患者使用抗生素（42%对30%，P = 0.018）、抗癫痫药（16%对5%，P = 0.000）、抗精神病药（35%对17%，P = 0.000）和慢性阻塞性肺疾病（COPD）药物（14%对7%，P = 0.008）的比例更高。与普通人群相比，HIV感染患者使用抗生素和抗精神病药的持续时间更长（P < 0.05）。
老年HIV阳性患者经常服用更多的合并用药，这增加了不良事件、与其他药物相互作用的风险，并可能导致治疗依从性较差。
