Current Opinion in Infectious Diseases, Год журнала: 2024, Номер unknown
Опубликована: Ноя. 27, 2024
To describe patient-centred multiciplinary management and care of people with HIV presenting cognitive disorders.
Язык: Английский
Journal of the International AIDS Society, Год журнала: 2020, Номер 23(2)
Опубликована: Фев. 1, 2020
The availability of potent antiretroviral therapy has transformed HIV infection into a chronic disease such that people living with (PLWH) have near normal life expectancy. However, there are continuing challenges in managing infection, particularly older patients, who often experience age-related comorbidities resulting complex polypharmacy and an increased risk for drug-drug interactions. Furthermore, physiological changes may affect the pharmacokinetics pharmacodynamics both antiretrovirals comedications thereby predisposing elderly to adverse drug reactions. This review provides overview therapeutic when treating PLWH (i.e. >65 years). Particular emphasis is placed on interactions other common prescribing issues inappropriate use, cascade, drug-disease interaction) encountered PLWH.
Язык: Английский
Процитировано
146
Journal of Prescribing Practice, Год журнала: 2024, Номер 6(9), С. 374 - 381
Опубликована: Сен. 2, 2024
As the population ages, understanding unique pharmacokinetic profiles of older adults is crucial for effective and safe medication management. This article provides an overview changes that occur with ageing, including alterations in absorption, distribution, metabolism, excretion. Emphasising implications prescribing practice, highlights common challenges strategies optimising pharmacotherapy patients. By recognising physiological potential drug interactions, healthcare providers can tailor their practices to improve therapeutic outcomes minimise adverse effects this vulnerable population.
Язык: Английский
Процитировано
17
HIV Research & Clinical Practice, Год журнала: 2025, Номер 26(1)
Опубликована: Фев. 12, 2025
Background: BICtegravir Single Tablet Regimen (BICSTaR) is an observational cohort study evaluating the effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in treatment-naïve (TN) treatment-experienced (TE) people with HIV. Objective: To present final pooled 24-month outcomes for full cohort. Methods: Prospective data were from TN TE adults HIV initiating B/F/TAF routine clinical practice across 14 countries (data collection: 25/06/2018–29/12/2023). Outcomes at 24 months included virologic suppression (HIV-1 RNA <50 copies/mL), immunologic (change CD4 cell count CD4/CD8 ratio), persistence, safety. also analysed key populations. Results: Of 2,074 (483 TN, 1,591 TE) participants included, most male (85%), White (70%), had ≥1 comorbidity (66%). Median (Q1, Q3) age was 45 (35, 54) years. At months, 94% 96% HIV-1 copies/mL (missing = excluded analysis). These values 88% 86%, respectively, a discontinuation failure analysis. Effectiveness remained high all populations months. increased by 257 (127, 447) cells/µL 40 (–70, 153) (both p < 0.001). There no reported treatment-emergent resistance to B/F/TAF. Persistence (TN, 95%; TE, 91%). Drug-related adverse events occurred 11% 12% participants, leading 5%. Conclusions: generally well tolerated over persistence observed among broad range
Язык: Английский
Процитировано
1
Current Opinion in HIV and AIDS, Год журнала: 2019, Номер 15(2), С. 126 - 133
Опубликована: Дек. 12, 2019
Update findings regarding polypharmacy among people with HIV (PWH) and consider what research is most needed.
Язык: Английский
Процитировано
54
Drugs & Aging, Год журнала: 2023, Номер 40(3), С. 179 - 240
Опубликована: Янв. 20, 2023
Older people living with HIV (PLWH) are at increased risks of co-morbidities and polypharmacy. However, little is known about factors affecting their needs concerns medicines. This systematic review aims to describe these identify interventions improve medicine optimisation outcomes in older PLWH. Multiple databases grey literature were searched from inception February 2022 including MEDLINE, CINAHL, PsycInfo, PsychArticles, the Cochrane Database Systematic Reviews Controlled Register Trials, Abstracts Social Gerontology, Academic Search Complete. Studies reporting interventions/issues PLWH (sample populations mean/median age ≥ 50 years; any aspect optimisation, or concerns). Quality assessments completed by means critical appraisal checklists for each study design. Title abstract screening was led one reviewer a sample reviewed independently two reviewers. Full-paper reviews author 20% Data extracted three independent reviewers using standardised data extraction forms synthesised according reported. summarised include key themes, concerns, summary intervention. Seventy-nine (n = 79) studies met eligibility criteria, most which originated USA 36). A few Australia 5), Canada Spain 9), UK 5). Ten Sub-Saharan Africa (Kenya n 1, South 6, Tanzania Uganda Zimbabwe 1). The rest China 1), France Germany Italy Netherlands Pakistan Switzerland Saudi Arabia 1) Ukraine Publication dates ranged 2002 2022. Sample sizes 10 15,602 across studies. PLWH's experience issues medicines co-morbidities, health-related quality life, polypharmacy, drug interactions, adverse reactions, adherence, burden, treatment stigma, social support, patient-healthcare provider relationships. Nine identified target persons, five aimed improving medication reduce self-management initiatives. Further in-depth research needed understand experiences priority issues. Adherence-focused predominant, but there scarcity this population. Multi-faceted achieve registered PROSPERO registration number: CRD42020188448.
Язык: Английский
Процитировано
14
HIV Medicine, Год журнала: 2023, Номер 24(S2), С. 8 - 19
Опубликована: Март 1, 2023
Abstract Objectives In recent decades, the needs of people living with HIV have evolved as life expectancy has greatly improved. Now, a new definition long‐term success (LTS) is necessary to help address multifaceted all HIV. Methods We conducted two‐phase research programme delineate range experiences The insights garnered from these phases were explored in series expert‐led workshops, which led development and refinement LTS framework. Results generated identified themes that form part LTS. These subsequently incorporated into framework, includes five outcome pillars: sustained undetectable viral load, minimal impact treatment clinical monitoring, optimized health‐related quality life, lifelong integration healthcare, freedom stigma discrimination. A supporting statements also developed by expert panel achievement each pillars. Conclusions framework offers comprehensive person‐centric approach that, if achieved, could improve well‐being support vision ‘every person being able live their best life’.
Язык: Английский
Процитировано
14
Trends in Molecular Medicine, Год журнала: 2024, Номер 30(11), С. 1076 - 1089
Опубликована: Июль 1, 2024
Язык: Английский
Процитировано
5
Patient Preference and Adherence, Год журнала: 2022, Номер Volume 16, С. 41 - 49
Опубликована: Янв. 1, 2022
Purpose: People living with HIV (PLWHIV) are susceptible to non-communicable diseases (NCDs) because of aging and infections. This means that the number non-HIV medications increases, along issues polypharmacy medication-related burden. The purpose this study was identify current situation burden among PLWHIV aged 50 above, as well relation between antiretroviral therapy (ART) adherence. Patients Methods: A cross-sectional conducted 185 participants recruited from two clinics in Yuelu District Center for Disease Control (CDC) Changsha First Hospital Hunan, China. Participants filled questionnaires about comorbidities, polypharmacy, burden, ART adherence sociodemographic characteristics. Results: Among participants, 40% were receiving PLWHIV, who female ( β = 5.946; 95% CI 1.354, 10.541), had a lower monthly income − 4.777; 6.923, 2.632), took more drugs 2.200; 1.167, 3.233) likely report higher level score negatively associated rs 0.250 p 0.001). Conclusion: findings suggest attention should be paid targeted interventions developed reduce older PLWHIV. Keywords: AIDS, aging, comorbidity, potential drug–drug interaction, medication
Язык: Английский
Процитировано
16
Clinics in Geriatric Medicine, Год журнала: 2024, Номер 40(2), С. 285 - 298
Опубликована: Янв. 21, 2024
Язык: Английский
Процитировано
3
Geriatrics, Год журнала: 2020, Номер 5(4), С. 81 - 81
Опубликована: Окт. 19, 2020
As life expectancy in people living with HIV (PLWH) has increased, the focus of management shifted to preventing and treating chronic illnesses, but few services exist for assessment these individuals. Here, we provide an initial description a geriatric service present data from evaluation undertaken clinic. We conducted first 52 patients seen clinic between 2016 2019. patient demographic data, outcomes, diagnoses given, interventions delivered those The average age attendees was 67. Primary reasons referral included complex comorbidities, polypharmacy, suspected syndrome (falls, frailty, poor mobility, or cognitive decline). median (range) number comorbidities comedications (non-antiretrovirals) 7 (2-19) 9 (1-15), respectively. All had undetectable viral load. Geriatric syndromes were observed 26 (50%) reviewed clinic, frailty mental health disease being most common syndromes. Interventions offered combination antiretroviral therapy modification, further investigations, signposting rehabilitation social care services, in-clinic advice. High levels acceptability among healthcare professionals reported. suggests that specialist might play role older
Язык: Английский
Процитировано
25