La Gestione Delle Pwh - Le Comorbidità Metaboliche

Future projections estimate that the proportion of older people (aged ≥ 50 years) living with human immunodeficiency virus (PWH) is growing and this number is expected to keep increasing. Global aging is accompanied by an increased prevalence of age-related comorbidities, multimorbidity, polypharmacy, cognitive decline, depression, bone impairment, and frailty that are detected more frequently and/or occur at an earlier age among PWH, compared with the general population.

In this context, a geriatric assessment could provide a complete view of a patient's function, cognition, and health, and it could improve prognosis, treatment decisions and could enhance quality of care. Furthermore, management of the older PWH includes the importance of an early diagnosis and treatment, preventative measures for comorbidities: simplifying medication regimen thereby reducing the burden of polypharmacy, and frailty.

In this perspective, the concept of appropriateness of medication prescribing, feasibility of deprescribing, assessment of physical performance and frailty have become a challenge to the correct management of older PWH. Modena HIV Metabolic Clinic (MHMC) Preceptorship program offers a 3 days educational program with both clinical activities with clinical practice and lectures, and it aims: to provide knowledge to clinicians to tailor treatment regimens according to age, HIV duration, multimorbidity, polypharmacy and vaccination in older PWH; to recognise prevent and manage frailty and geriatric syndromes in older PWH; to discuss the importance of patient reported outcomes measurements and their applications in aging clinic; to offer strategies that may improve the future management of people aging with HIV through the presentation of a patient centred clinical approach.