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However, there are continuing challenges in managing HIV infection, particularly in older patients, who often experience age\u2010related comorbidities resulting in complex polypharmacy and an increased risk for drug\u2010drug interactions. Furthermore, age\u2010related physiological changes may affect the pharmacokinetics and pharmacodynamics of both antiretrovirals and comedications thereby predisposing elderly to adverse drug reactions. This review provides an overview of the therapeutic challenges when treating elderly PLWH (i.e. &gt;65\u00a0years). Particular emphasis is placed on drug\u2010drug interactions and other common prescribing issues (i.e. inappropriate drug use, prescribing cascade, drug\u2010disease interaction) encountered in elderly PLWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Prescribing issues are common in elderly PLWH due to the presence of age\u2010related comorbidities, organ dysfunction and physiological changes leading to a higher risk for drug\u2010drug interactions, drugs dosage errors and inappropriate drug use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The high prevalence of prescribing issues in elderly PLWH highlights the need for ongoing education on prescribing principles and the optimal management of individual patients. The knowledge of adverse health outcomes associated with polypharmacy and inappropriate prescribing should ensure that there are interventions to prevent harm including medication reconciliation, medication review and medication prioritization according to the risks\/benefits for each patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.25449","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T08:15:53Z","timestamp":1580717753000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":166,"title":["The challenge of HIV treatment in an era of polypharmacy"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7381-4799","authenticated-orcid":false,"given":"David","family":"Back","sequence":"first","affiliation":[{"name":"Department of Molecular and Clinical Pharmacology University of Liverpool Liverpool United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catia","family":"Marzolini","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Pharmacology University of Liverpool Liverpool United Kingdom"},{"name":"Division of Infectious Diseases and Hospital Epidemiology Departments of Medicine and Clinical Research University Hospital of Basel and University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30066-8"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001335"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081355"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000298"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118531"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00056-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0186638"},{"key":"e_1_2_6_9_1","unstructured":"World Health Organization.Definition of an older or elderly person[cited 2019 Sep 1]. 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