Background: Raltegravir (RAL) is considered one of the better-tolerated antiretroviral
medications, due to limited side effects and minimal drug-drug interactions.
Matherials and Methods: We retrospectively evaluated 96 HIV+, over 60 years old, experienced
patients who had switched from any antiretroviral drug to raltegravir-based nuc-sparing or standard
nucleoside-backbone regimens. A control group with patients aged under 60 years old was included.
Results: The median age of the patients was 66 years (IQR 10.5) (77 M, 19 F); the median time horizon
of follow-up was 4 years (IQR 5). HIV-RNA at baseline was undetectable for more than 6
months in most of the patients. Median CD4+ count was 453 cells/mmc (IQR 379). 49 patients had
AIDS history. All the patients were assuming concomitant medications. No adverse effect attributed
to the use of raltegravir was reported in the medical records. Only 2 patients presented virological
failure, whereas viremic blips were observed in 10 patients. After switching to RAL-containing
regimens triglycerides values showed a statistically significant reduction from a median value of
172 (IQR 105.5) mg/dl to 129 mg/dl (IQR 73) (p=0,0001). Switching to a standard regimens was
associated with a marked reduction of triglycerides. Cholesterol levels were reduced at the time of
follow-up (T2) but no significant modifications were observed when patients which had introduced
drugs to treat dislypidemia were removed from the analysis; in contrast, triglycerides reduction was
also confirmed in this sub-group. Patients presented higher levels of CD4+ at T2 and reduced platelet
count [from 230 300/mmc (SD 123 527) to 197 125/mmc (SD 66 377), p=0,04]. Similar trends
were observed in younger patients.
Conclusion: RAL-containing regimens are safe and highly effective in the older population. RALtreatment
is associated with the reduction of triglycerides and platelets count in the older population.