title: HIV: a growing concern in the elderly population.
abstract: HIV infections are a growing concern in the elderly as a result of improvements in therapeutics and monitoring, which have extended the life span for this HIV-infected population. Elderly patients potentially are more complicated to treat than younger HIV-infected individuals because of comorbidities and the physiological effects of aging on pharmacokinetics and pharmacodynamics. The patient, a 67-year-old African-American HIV-infected male, presents to the transitional care unit of university-affiliated hospital refusing to take medications and undergo laboratory testing, including blood draws. This patient's treatment is further complicated by poor renal function, medications with potential interactions, and a recent diagnosis of depression. This case demonstrates treatment and monitoring of an elderly patient with HIV and reveals the complications associated with this disease state. Specifically, it identifies nonadherence to medications and a lack of laboratory results, which affect the efficacy of treatment and monitoring, medication adjustments based on metabolism and renal excretion, monitoring of adverse effects of HIV and antiretroviral therapy, and comorbid conditions that may be linked to HIV and antiretroviral therapy such as depression and bone disease. Education on HIV medications, monitoring, and standards of care for pharmacists working with the geriatric population is warranted and should be emphasized as the HIV-infected elderly population continues to grow.
authors.affiliation: St. Louis College of Pharmacy, St. Louis, MO, USA. scott.vouri@stlcop.edu
authors.forename: Scott Martin
authors.initials: SM
authors.lastname: Vouri
authors.forename: Amie Taggart
authors.initials: AT
authors.lastname: Blaszczyk
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000368:Aged / Q000706:statistics & numerical data*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000959:Antihypertensive Agents; D017963:Azithromycin / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003866:Depressive Disorder / Q000150:complications; D004110:Diltiazem / Q000627:therapeutic use; D004347:Drug Interactions; D016903:Drug Monitoring; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D061466:Lopinavir / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance; D010595:Pharmacists; D051437:Renal Insufficiency / Q000150:complications; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D000959:Antihypertensive Agents; D061466:Lopinavir; D015215:Zidovudine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D017963:Azithromycin; D004110:Diltiazem