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P106 Up to half of geriatric people living with HIV are treated with 2-drug INSTI-based regimens
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P106 Up to half of geriatric people living with HIV are treated with 2-drug INSTI-based regimens
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Journal Article
P106 Up to half of geriatric people living with HIV are treated with 2-drug INSTI-based regimens
2025
Overview
BackgroundPeople with HIV (PWH) are aging and may have a long history of HIV infection, long exposure to antivirals, increasing comorbidities and polypharmacy. We aim to assess the use of two drug regimens (2DR) in geriatric population of PWH.MaterialsThis is a cross-sectional study in PWH older than 64 years and currently followed up in 3 HIV centers in northern Italy. Data were collected from medical reports or electronic database in February 2025 and subjects with the last visit within 9 months and currently receiving ARVs were included. Polypharmacy (PP) was defined as 5 or more non-HIV drugs. The primary endpoint was the use of 2DR, secondary end-points were prevalence and characterization of comorbidities, polypharmacy and viroimmunological status. Multiple cox regression model was used to assess factors associated to 2DR treatmentsResults655 PWH were included (80%, males, median (IQR) age was 70 (66–75), 54% heterosex, 23% MSM, 13% past-IVUs, 95% were Caucasians. A total of 315 (48%), 243 (37%) and 42 (6.4%) subjects had received <3, 3–6 and more than 6 lines of HIV therapy, respectively. Median (IQR) duration of HIV infection was 25 (19–33) years, median (IQR) nadir and current CD4 count were 146 (3–50) and 689 (504–926) cells/mL, respectively, while 611 (93%) subjects had plasma HIV RNA <50 copies/ml. A total of 18 (3%), 212 (36%), 304 (53%) and 43 (7.5%) individuals had 0, 1–2, 3–5 and ≥6 comorbidities, respectively. A total of 266/525 (50.6%) had polypharmacy, while 21/570 (3.7%) were HBsAg positive. Overall, primary RAMs were documented in 159 subjects in NRTI- (124), NNRTI- (103), PI- (68) and INI- (10) regions, respectively.A total of 329 (50.2%) and 322 (49%) were on 2DR and ≥3DR, respectively; 4 were on DRV-monotherapy. 2DRs were as follows: DTG/3TC (175/329, 53.2%), boosted PI+X (57, 17%), DTG/RPV (53, 16%), CAB/RPV (17, 5%), DTG/DOR (13, 4%) and others (15, 4.5%). The most used 3DRs were BIC/F/TAF (160/322, 49.6%), RPV/F/TAF (65, 20.2%) and DTG/ABC/3TC (22, 6.8%) and DRVc/F/TAF (20, 6.2%). Overall, boosted PIs were used in 100 (15.2%) individuals, in different combinations. At Cox regression analysis, factors associated with a higher probability of being on 2DR were the number of comorbidities (HR of ≥ 6 comorbidities compared to 0–2: 0.52, 95% CI 0.3–0.9, global p <0.001), the presence of major mutations (HR = 0.67, 95%CI 0.48–0.94; p = 0.02) and the value of nadir CD4+ count (increase of 50, HR = 1.08, 95%CI 1.02–1.15; p = 0.015) (table 1).Abstract P106 Table 1Conclusions2DRs, INSTI-based and in different combinations, are used in up to half of geriatric PWH, with DTG/3TC being the most frequent, while CAB/RPV LA underused.
Publisher
BMJ Publishing Group LTD
Subject
