Background The availability of more potent drugs, with fewer adverse effects, and new therapeutic strategies, such as simplification and ritonavir-boosted protease inhibitor (PI/r) monotherapy have changed the antiretroviral therapeutic profile of HIV patients.

Purpose To analyse the relationship between antiretroviral therapy (ART), adherence and health-related quality of life (HRQL) in HIV patients older than 50 years, with moderate-high cardiovascular risk (CVR), integrated in a pharmacotherapy follow-up service.

Material and methods Patients on antiretroviral therapy aged over 50, with a CVR ≥ 2 (assessed by the risk score), who signed an informed consent were included. Study variables were obtained through interview, clinical history and pharmacy records. The HRQL was assessed through the MOS-HIV questionnaire¹ and the adherence by the SMAQ questionnaire and electronic dispensing record.

Results We included 73 patients, 84% males, median age 54 years (IQR 52–59) who had been diagnosed with HIV for 17 years (IQR 13–20). Median CD4 count 684 cells/mm³ (IQR 469–882) and 93% with undetectable viral load. Adherence according to dispensing records was 93% (89–98) and by SMAQ, 67% were adherent. The most prescribed antiretrovirals were darunavir and tenofovir, 32% of patients had been prescribed an unconventional regimen and 29% PI/r monotherapy, median of three tablets/day (IQR 3–4) and 75% once daily. The domains of HRQL, physical (PHS) and mental (MHS) were significantly higher in: patients over 60 years, patients with more than 10 years of ART and with fewer than 3 tablets/day. Patients not on IP/r had higher scores on all dimensions of HRQL with significant differences in cognitive functioning (p = 0.015).

Conclusion Patients presented antiretroviral therapy in unconventional combinations, more than 90% adherence and undetectable viral load. Antiretroviral treatment strategy could improve the quality of life perceived by the patient.

Reference

1. Wu AW, Rubin HR, Mathews WC, et al. A health status questionnaire using 30 items from the Medical Outcomes Study: Preliminary validation in persons with early HIV infection. Medical Care 1991;29(8):786–98

ReferenceNo conflict of interest.