Successful management of HIV infection as a chronic condition has resulted in a demographic shift where the proportion of people living with HIV (PLWH) older than 50 years is steadily increasing. A dedicated clinic to PLWH older than 50 years was established at Chelsea and Westminster Hospital in January 2009 and then extended to HIV services across the directorate. We report the results of a service evaluation reviewing 10 years of activities of this clinic between January 2009 and 2019. We aimed to estimate the prevalence of major noninfectious comorbidities, polypharmacy (≥5 medications), and multimorbidity (≥2 non-HIV-related comorbidities) and describe algorithms devised for use in HIV outpatient clinics across the directorate. A cohort of 744 PLWH older than 50 years attending this service were analyzed (93% male; mean age of 56 ± 5.5 years; 84% white ethnicity); 97.7% were on antiretroviral treatment and 95.9% had undetectable HIV-RNA at the time of evaluation. The most common comorbidities diagnosed were dyslipidemia (50.1%), hypertension (21.5%), mental health disorders (depression and/or anxiety disorders, 15.7%), osteoporosis (12.2%), obesity (11.9%), chronic kidney disease (7.5%), and diabetes (5.8%). Low vitamin D levels were found in 62% of patients [43% with vitamin D deficiency (<40 mmol/liter) and 57% with vitamin D insufficiency (40–70 mmol/liter)]. The overall prevalence of polypharmacy and multimorbidity was 46.6% and 69.3%, respectively. This study showed significant rates of non-HIV-related comorbidities and polypharmacy in PLWH older than 50 years, leading on to the implementation of clinical care pathways and new joint HIV/specialty clinics (cardiology, nephrology, neurology, metabolic, menopause, and geriatric) to improve prevention, diagnosis, and management of major comorbidities in people aging with HIV.

中文翻译：

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切尔西和威斯敏斯特医院专门为艾滋病毒感染者开设的诊所的评估：10 年经验的结果

作为慢性病的 HIV 感染的成功管理导致了人口结构的转变，其中 50 岁以上的 HIV 感染者 (PLWH) 的比例正在稳步增加。2009 年 1 月，切尔西和威斯敏斯特医院为 50 岁以上的 PLWH 设立了专门诊所，然后扩展到整个部门的 HIV 服务。我们报告了一项服务评估的结果，该评估回顾了该诊所 2009 年 1 月至 2019 年 10 年的活动。我们旨在估计主要非感染性合并症、多种药物（≥5 种药物）和多种疾病（≥2 种非 HIV 相关疾病）的患病率。合并症）并描述了为在整个董事会的 HIV 门诊中使用而设计的算法。分析了参加这项服务的 744 名 50 岁以上的 PLWH 队列（93% 为男性；平均年龄为 56 ± 5.5 岁；84% 白人）；97.7% 接受抗逆转录病毒治疗，95.9% 在评估时检测不到 HIV-RNA。最常见的合并症是血脂异常（50.1%）、高血压（21.5%）、精神健康障碍（抑郁和/或焦虑症，15.7%）、骨质疏松症（12.2%）、肥胖（11.9%）、慢性肾病（7.5 %）和糖尿病（5.8%）。62% 的患者发现维生素 D 水平低[43% 的患者维生素 D 缺乏（<40 mmol/L），57% 的患者维生素 D 不足（40-70 mmol/L）]。多种药物和多种疾病的总体患病率分别为 46.6% 和 69.3%。该研究显示，在 50 岁以上的 PLWH 中，非 HIV 相关合并症和多种药物的发生率很高，这导致临床护理路径和新的 HIV/专科联合诊所（心脏病学、