The availability of potent antiretroviral therapy has transformed HIV infection into a chronic disease such that people living with HIV (PLWH) have a near normal life expectancy. However, there are continuing challenges in managing HIV infection, particularly in older patients, who often experience age‐related comorbidities resulting in complex polypharmacy and an increased risk for drug‐drug interactions. Furthermore, age‐related 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. >65 years). Particular emphasis is placed on drug‐drug interactions and other common prescribing issues (i.e. inappropriate drug use, prescribing cascade, drug‐disease interaction) encountered in elderly PLWH.

中文翻译：

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多药时代 HIV 治疗的挑战

有效的抗逆转录病毒疗法已将 HIV 感染转变为一种慢性疾病，因此 HIV 感染者 (PLWH) 的预期寿命接近正常。然而，在管理 HIV 感染方面仍然存在挑战，特别是在老年患者中，他们经常患有与年龄相关的合并症，导致复杂的多重用药和药物相互作用风险增加。此外，与年龄相关的生理变化可能会影响抗逆转录病毒药物和药物的药代动力学和药效学，从而使老年人容易发生药物不良反应。本综述概述了治疗老年 PLWH（即 >65 岁）时的治疗挑战。特别强调药物之间的相互作用和其他常见的处方问题（即不适当的药物使用，