{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T22:20:34Z","timestamp":1788733234245,"version":"build-2803163510"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T00:00:00Z","timestamp":1720828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Theratecnologies"},{"DOI":"10.13039\/100009947","name":"Merck Sharp & Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate polypharmacy, anticholinergic burden (ACB) and drug\u2013drug interactions (DDIs) in people with four-class-resistant HIV (4DR-PWH).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a cross-sectional study, including 4DR-PWH from the PRESTIGIO Registry taking at least one non-antiretroviral drug. Polypharmacy was defined as taking five or more non-antiretroviral drugs. ACB was calculated using the ACB scale: 0\u200a=\u200ano AC effect, 1\u20132\u200a=\u200alow\/moderate risk, \u22653\u200a=\u200ahigh AC risk. Participants\u2019 characteristics by ACB score were compared using the Kruskal\u2013Wallis test, and Spearman's correlation coefficient was used to assess linear relationships. DDIs were evaluated using the Liverpool database.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 172 4DR-PLWH were evaluated: 75.6% males, median age 49.9\u2005years (IQR\u200a=\u200a45.6\u201356), 62 (27.1%) on polypharmacy, 124 (72.1%) using a boosting agent and 72 (41.8%) with four or more antiretrovirals. Based on ACB, 128 (74.45%), 33 (19.2%) and 11 (6.4%) had a no, low\/moderate and high AC risk, respectively. The most common AC drugs were \u03b2-blockers (12.2%), diuretics (8.7%) and antidepressants (8.7%). The high ACB was significantly related to the number of drugs\/person (r\u200a=\u200a0.33, P\u200a&amp;lt;\u200a0.0001) and the number of clinical events (r\u200a=\u200a0.222, P\u200a=\u200a0.004). Overall, 258 DDIs were found between antiretrovirals and co-medications in 115 (66.8%) PWH, and 14 (8.1%) PWH received contraindicated drug combinations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In 4DR-PWH, polypharmacy, DDIs and the proportion of people with moderate\/high AC burden were high. In 4DR-PWH undetectability achievement and maintenance is the priority and use of boosted PIs is common. A strict collaboration (infectious diseases specialists, virologists, pharmacologists) is needed to limit the risk of ACB and DDIs and to explore the advantages of new antiretrovirals.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae190","type":"journal-article","created":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T11:38:01Z","timestamp":1720870681000},"page":"2163-2169","source":"Crossref","is-referenced-by-count":8,"title":["Polypharmacy, anticholinergic burden and drug\u2013drug interaction assessment in people with four-class-resistant HIV: data from the PRESTIGIO registry"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0263-0703","authenticated-orcid":false,"given":"Maria","family":"Mazzitelli","sequence":"first","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Padua University Hospital , Padua , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Pontillo","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6548-3427","authenticated-orcid":false,"given":"Tommaso","family":"Clemente","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Vita-Salute University, San Raffaele Scientific Institute , Milan , Italy"},{"name":"Infectious Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Hospital , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1436-5089","authenticated-orcid":false,"given":"Antonio","family":"Di Biagio","sequence":"additional","affiliation":[{"name":"Clinica Malattie Infettive, IRCCS Ospedale Policlinico San Martino , Genova, Liguria , Italy"},{"name":"Department of Health Sciences (DiSSal), University of Genoa , Genoa , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cenderello","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, Sanremo Hospital, ASL 1 Imperiese , Sanremo , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0375-9990","authenticated-orcid":false,"given":"Stefano","family":"Rusconi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Ovest Milanese, Legnano General Hospital , Legnano , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Menzaghi","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, ASST della Valle Olona , Busto Arsizio , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Fornabaio","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, ASST Cremona , Cremona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Garlassi","sequence":"additional","affiliation":[{"name":"Malattie Infettive Arcispedale S. 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