Background and importance Advances in antiretroviral treatment (ART) have resulted in an increase in life expectancy in HIV patients. For this reason, a rise in comorbidities related to chronic diseases and long-term toxicities of ART have been observed, becoming the main causes of morbidity and mortality among patients with HIV.
Aim and objectives To evaluate the presence of cardiovascular, bone and kidney alterations in a cohort of HIV patients aged ≥60 years.
Material and methods Observational, descriptive and retrospective study (using medical history and prescription records) of patients with HIV aged ≥60 years with ART in February 2021 that were under treatment since a previous cross-sectional study carried out in 2012 were selected.
Demographic (age and sex), clinical (time since HIV diagnosis, diagnosis of hypertension and diabetes mellitus (DM), cardiovascular risk scala REGICOR, cardiovascular and renal events and diagnoses of osteopenia/osteoporosis and CD4 lymphocyte and viral load (VL)) and pharmacological (chronic medication not related to ART, ART change number and reasons for change) were collected in 2012 and 2021.
Results 51 HIV patients with mean±SD age of 66.4±6.2 years were analysed. 60.8% were men with a mean age of 22.3±8.1 years since diagnosis.
In 2012 and 2021, patients diagnosed with hypertension were 15.7% and 35.3%, respectively, DM was 11.8% and 25.5%, respectively, and REGICOR was 5% and 7%, respectively.
During the considered period, 17.6% had a cardiovascular event, 13.7% were diagnosed with kidney disease and 49.0% with osteopenia/osteoporosis.7.8% had some bone event.
In 2012 and 2021, mean CD4 lymphocytes were 601.7 (±312.7) and 722.7 (±310.6) cells/mm3, respectively, and 90.2% had undetectable VL in both years.
In 2012, 15.7% of the patients were receiving lipid-lowering therapy, 5.9% antiplatelet/anticoagulant and 11.8% oral antidiabetic drugs/insulin. In 2021, the equivalent figures were 47.1%, 15.7% and 25.5%, respectively.
19.6% started treatment with calcium, cholecalciferol and/or bisphosphonate during the period.
In total, 113 treatment changes were made: musculoskeletal disorders (23%), simplification (21.2%), metabolism disorders (11.5%), virological failure (8.8%), resistance and kidney disorders (8.0%), interactions (7.1%) and others (12.6%).
Conclusion and relevance Cardiovascular, kidney and bone alterations are frequent in HIV patients aged ≥60 years. Treatment changes are conditioned by patients’ comorbidities and are focused on avoiding long-term toxicities.
Conflict of interest No conflict of interest