HIV-positive women have higher prevalence of comorbidities and anticholinergic burden: assessment of the HIV-positive population from Menorca (Balearic Islands)

Abstract

Currently, the management of comorbidities and polypharmacy in HIV-infected patients requires a coordinated action, with special focus on gender differences. Observational, cross-sectional study was conducted to study the HIV population from Menorca (Illes Balears). Adult HIV-positive individuals on antiretroviral treatment attending the pharmacy service from Hospital Mateu Orfila (Menorca) were included. In a single visit, demographical and clinical characteristics, comorbidities and cotreatments were collected. Anticholinergic burden (Drug Burden Index, DBI), drug-to-drug interactions (BOT PLUS database) and symptoms associated with HIV treatment (HIV-SI index) were assessed. A total of 223 patients were included, 68.2% men, with a median age of 53.00 (44.50-58.00) years, median BMI of 24.07, 47.73% smokers and 9.90% drug consumers. Women had more advanced stages of the disease and significantly more symptoms (cough and anxiety) versus men (p = .033 and p = .048, respectively). Moreover higher exposures to anticholinergic drugs (DBI 0.51 vs. 0.27) were reported, together with more frequency of drug-to-drug interactions (57.7% vs. 37.5%; p = .005) that increased with age. Red interactions were more frequently reported in PI (2.69%), NNRTIs (1.92%) and booster drugs (1.92%). These results support the need to implement specific measures for the management of HIV-infected women and tools to assess polypharmacy and risk of drug-to-drug interactions.

Potentially Inappropriate Prescribing in Older People Living With HIV: A Scoping Review

“…1). Most studies were single centre 22,29,31–33,39–42,44,45,48–52,54,57,59–66 and conducted in Europe. 13,19,28,30–33,39,41,43–51,53,56–63,65,67 The sample size ranged from 2 to 1292 participants, and the population was majority male.…”

“…Most studies were single centre 22,29,31–33,39–42,44,45,48–52,54,57,59–66 and conducted in Europe. 13,19,28,30–33,39,41,43–51,53,56–63,65,67 The sample size ranged from 2 to 1292 participants, and the population was majority male. Twenty-eight studies were cross-sectional, 19,27,28,30–33,39–41,44,45,47–51,53,55,56,61–67 3 were prospective cohort studies, 43,46,57 3 were prospective intervention studies with no control group, 22,59,60 2 nonrandomized controlled studies, 42,52 and 1 randomized controlled study, 58 1 case–control study, 29 and 1 case-report.…”

“…13,19,28,30–33,39,41,43–51,53,56–63,65,67 The sample size ranged from 2 to 1292 participants, and the population was majority male. Twenty-eight studies were cross-sectional, 19,27,28,30–33,39–41,44,45,47–51,53,55,56,61–67 3 were prospective cohort studies, 43,46,57 3 were prospective intervention studies with no control group, 22,59,60 2 nonrandomized controlled studies, 42,52 and 1 randomized controlled study, 58 1 case–control study, 29 and 1 case-report. 54 In most studies, investigators used explicit criteria (Table 1), and in others, implicit criteria or a combination of both (Table 2).…”

“…PRISMA diagram of flow of studies. A total of 39 studies met the inclusion criteria 11,13,19,22,27–33,39–67 reported in 50 articles.…”

“…26 Researchers have used some of these tools to evaluate the prescription in PLHIV and have found a high prevalence of some criteria. 19,22,[27][28][29][30] In general, a large proportion of PLHIV use benzodiazepines over a long time, 29,31 contraindicated nonsteroidal anti-inflammatory agents, 32 have a high burden of anticholinergic or sedative medications, 27,33 and suffer from a lack of prescription of calcium and vitamin D, 30,32 some vaccines, 32 or cardiovascular agents in PLHIV at risk, 30 among others. Although ART has been reduced to the minimum possible difficulty (ie, a daily tablet), 34 pharmacotherapeutic complexity of the comedication, PIMs, and polypharmacy remain a problem to solve.…”