HIV, aging, and adherence: an update and future directions : Current Opinion in HIV and AIDS

Secondary Logo

Journal Logo

HIV AND AGING: Edited by Kristine M. Erlandson

HIV, aging, and adherence: an update and future directions

Mann, Sarah Czarna; Castillo-Mancilla, Jose R.

Author Information
Current Opinion in HIV and AIDS 15(2):p 134-141, March 2020. | DOI: 10.1097/COH.0000000000000615


Purpose of review 

To highlight recent data on antiretroviral adherence in older people living with HIV (PLWH), describe the most relevant pharmacokinetic antiretroviral studies, and identify critical research gaps in this population.

Recent findings 

Overall, studies have found that older PLWH are more likely to be adherent to antiretroviral therapy (ART). Although multiple methods to measure adherence are available (self-report, pharmacy refills, electronic device monitors, drug concentrations), there is currently no ‘gold standard’ adherence measure or sufficient evidence to suggest a preferred method in older patients. Recently, studies evaluating antiretroviral concentrations in hair and dried blood spots in older patients identified no major differences when compared with younger individuals. Similarly, although pharmacokinetic studies in older PLWH are scarce, most data reveal no significant pharmacokinetic differences in the aging population. Furthermore, no specific guidelines or treatment recommendations regarding ART dose modification or long-term toxicity in aging PLWH are available, mostly because of the exclusion of this population in clinical trials.


How aging influences adherence and pharmacokinetics remains poorly understood. As the population of older PLWH increases, research focusing on adherence, toxicity, drug--drug interactions, and the influence of comorbidities is needed.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

You can read the full text of this article if you:

Access through Ovid