Trisolini Pietro, Cammarota Simona, Citarella Anna, Fogliasecca Marianna, Alicchio Viviana, Antonacci Stefania, Giannini Romina, Lombardi Renato, Piccoli Mariantonietta, Pomarico Francesco, Procacci Cataldo, Siniscalco Antonino, Spennato Stefania, Saracino Annalisa, Lo Caputo Sergio
Hospital Pharmacy Unit, IRCCS National Institute of Research "Saverio De Bellis", 70013 Bari, Italy.
LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., 80143 Naples, Italy.
Viruses. 2025 Sep 5;17(9):1212. doi: 10.3390/v17091212.
Modern antiretroviral therapy (ART) has transformed HIV into a chronic, manageable condition. This retrospective analysis of administrative data from Apulia (Southern Italy) covering 2018-2023 evaluated demographic changes, ART regimen trends, adherence, and the use of antihypertensives, statins, and antidiabetics among people with HIV (PWH). Temporal trends were assessed using compound annual growth rate (CAGR). ART adherence was measured as proportion of days covered (PDC), categorized as <75%, 75-90%, and ≥90%. Over the study period, the proportion of PWH aged 18-54 declined, while those aged 55-64 and ≥65 increased (CAGRs: +10.9%, +14.3%). Use of single-tablet regimens rose from 45.1% to 79.6% (CAGR +12.1%), and integrase-based regimens increased from 52.0% to 69.0%, while protease inhibitor and multi-tablet regimens declined. Antihypertensives were the most prescribed concomitant drugs, followed by statins and antidiabetics (CAGRs: +5.8%, +9.7%, +9.5%). In 2023, 81.9% of subjects achieved PDC ≥ 90%, although lower adherence was observed in women and treatment-naïve individuals. These findings indicate a shift toward simplified, integrase-based regimens and high ART adherence, alongside a growing cardiometabolic burden. Tailored strategies are needed to support adherence, particularly in women and treatment-naïve individuals, and to address cardiovascular risk in aging PWH.
现代抗逆转录病毒疗法（ART）已将艾滋病转化为一种可慢性管理的疾病。这项对意大利南部普利亚地区2018年至2023年行政数据的回顾性分析，评估了艾滋病毒感染者（PWH）的人口结构变化、ART治疗方案趋势、依从性以及抗高血压药、他汀类药物和抗糖尿病药物的使用情况。使用复合年增长率（CAGR）评估时间趋势。ART依从性以服药天数比例（PDC）衡量，分为<75%、75 - 90%和≥90%。在研究期间，18 - 54岁的PWH比例下降，而55 - 64岁和≥65岁的比例上升（CAGR分别为+10.9%、+14.3%）。单片复方制剂的使用从45.1%升至79.6%（CAGR为+12.1%），基于整合酶的治疗方案从52.0%增至69.0%，而蛋白酶抑制剂和多片制剂方案减少。抗高血压药是最常开具的伴随药物，其次是他汀类药物和抗糖尿病药物（CAGR分别为+5.8%、+9.7%、+9.5%）。2023年，81.9%的受试者PDC≥90%，不过女性和初治个体的依从性较低。这些发现表明治疗方案正朝着简化的、基于整合酶的方案转变，且ART依从性较高，同时心脏代谢负担也在增加。需要制定针对性策略以支持依从性，尤其是针对女性和初治个体，并应对老年PWH的心血管风险。
