Clinical and demographic characteristics, and problems related to medication in patients with 50 or more years with recent diagnosis of HIV in Medellín, Colombia

Abstract

Introduction: multimorbidity, polypharmacy, and problems related to medication are common both, in aging people with HIV and in those diag-nosed in advanced ages. Objective: To describe the demographics, clinical characteristics, and problems related to medication in patients ≥ 50 years old with new diagnosis of HIV. Methods: A descriptive transversal study. This study included patients ≥ 50-year-old, with new diagnosis of infection with HIV, who attended four HIV healthcare programs in the city of Medellín, Colombia, between Ja-nuary 2013 and December 2016. Results: 493 patients were analyzed. 62.7% (n=309) were in WHO clinical stage 3. 49.5% (n=244) had at least one definitory condition of AIDS, with wasting syndrome (23.7%, n=117) and tuberculosis (16.8%, n=82) being the most frequent ones. At the time of diagnosis, the median of CD4 and viral load was 176 cells/mL (IQR 59-352) and 117,323 copies/mL (IQR 28,237-411,139), respectively. 59% (n=291) had non-infectious comorbidities, with the two most common being arterial hypertension (22.3%, n=110) and dys-lipidemia (14.2%, n=70). 66.1% (n=326) of patients had problems related to medication, being the most frequent: drug interactions (61.1%, n=301), po-lypharmacy with ARV drugs (53.1%), potentially inappropriate medication (7.9%, n=39), and high anticholinergic risk (2.4%, n=12). Conclusion: at the time of diagnosis, HIV-positive older adults frequently have multimorbidity, polypharmacy, and drug interactions. The diagnosis of HIV in this population is very delayed and the presence of opportunistic infections is frequent.