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. 2025 Sep 5;17(9):1212.
doi: 10.3390/v17091212.

Antiretroviral Adherence and Use of Antihypertensives, Statins, and Antidiabetics Among Elderly People with HIV: A 5-Year Real-World Study in Southern Italy

Pietro Trisolini  1 , Simona Cammarota  2 , Anna Citarella  2 , Marianna Fogliasecca  2 , Viviana Alicchio  3 , Stefania Antonacci  4 , Romina Giannini  5 , Renato Lombardi  6 , Mariantonietta Piccoli  7 , Francesco Pomarico  8 , Cataldo Procacci  9 , Antonino Siniscalco  10 , Stefania Spennato  3 , Annalisa Saracino  11 , Sergio Lo Caputo  12
Affiliations

Antiretroviral Adherence and Use of Antihypertensives, Statins, and Antidiabetics Among Elderly People with HIV: A 5-Year Real-World Study in Southern Italy

Pietro Trisolini et al. Viruses. .

Abstract

Modern antiretroviral therapy (ART) has transformed HIV into a chronic, manageable condition. This retrospective analysis of administrative data from Apulia (Southern Italy) covering 2018-2023 evaluated demographic changes, ART regimen trends, adherence, and the use of antihypertensives, statins, and antidiabetics among people with HIV (PWH). Temporal trends were assessed using compound annual growth rate (CAGR). ART adherence was measured as proportion of days covered (PDC), categorized as <75%, 75-90%, and ≥90%. Over the study period, the proportion of PWH aged 18-54 declined, while those aged 55-64 and ≥65 increased (CAGRs: +10.9%, +14.3%). Use of single-tablet regimens rose from 45.1% to 79.6% (CAGR +12.1%), and integrase-based regimens increased from 52.0% to 69.0%, while protease inhibitor and multi-tablet regimens declined. Antihypertensives were the most prescribed concomitant drugs, followed by statins and antidiabetics (CAGRs: +5.8%, +9.7%, +9.5%). In 2023, 81.9% of subjects achieved PDC ≥ 90%, although lower adherence was observed in women and treatment-naïve individuals. These findings indicate a shift toward simplified, integrase-based regimens and high ART adherence, alongside a growing cardiometabolic burden. Tailored strategies are needed to support adherence, particularly in women and treatment-naïve individuals, and to address cardiovascular risk in aging PWH.

Keywords: HIV; adherence; administrative data; aging; antiretroviral therapy.

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Conflict of interest statement

Sergio Lo Caputo has served as an advisor for Gilead, ViiV, Janssen-Cilag, GSK, MSD, and AstraZeneca. He has received speaker honoraria from Gilead, ViiV, MSD, GSK, and Janssen-Cilag, as well as travel support for attending meetings from Gilead, Janssen-Cilag, and ViiV. He has also received research grants from Gilead. Simona Cammarota, Anna Citarella and Marianna Fogliasecca are employees of LinkHealth Health Economics, Outcomes and Epidemiology s.r.l., which has received grants from several entities (Research Institutes, pharmaceutical companies, universities) for the performance of epidemiology and health economics studies. All other authors disclose no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Concomitant medications for PWH by year (2018–2022). (a) Antihypertensives. (b) Statins. (c) Antidiabetics. Abbreviations: PWH, people with HIV; CAGR, compound annual growth rate.
Figure 2
Figure 2
Adherence for people with HIV (2018–2022).
See this image and copyright information in PMC

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