ArticleThe Journal of antimicrobial chemotherapy2024
Use of different anticholinergic scales and their correlation with anticholinergic symptom burden in a cohort of people living with HIV.
Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Reply to: Comment on revisiting the association between anticholinergic burden and frailty in people with HIV.British journal of clinical pharmacology · 2026Article
- Anticholinergic burden interacts with age and AIDS history to amplify frailty in people with HIV.British journal of clinical pharmacology · 2026Article
- A multidisciplinary, AI-supported quality improvement intervention to manage polypharmacy in aging people with HIV.HIV medicine · 2026Article
- Cognitive and fine motor performance in people above 65 years of age with and without HIV.Scientific reports · 2026Article
- The Effects of Prescribed Medications on Depressive Symptoms and Neurocognitive Performance in People With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Article
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesHow to detect the clinical impact of anticholinergic (AC) burden in people with HIV (PWH) remains poorly investigated. We cross-sectionally described the prevalence and type of AC signs/symptoms and the screening accuracy of three AC scales in detecting their presence in a modern cohort of PWH.
methodsWe calculated AC Burden Scale (ABS), AC Risk Score (ARS) and AC Drug Score (ADS) in 721 adult PWH and recorded the presence of AC signs/symptoms over the previous 3 months. High AC risk was defined by ABS score ≥2, and ARS or ADS score ≥3. Comparisons among the scale were based on Cohen's inter-rater agreement, and their screening accuracy was assessed by receiver operating characteristics (ROC) curves and performance measures.
resultsWe enrolled 721 PWH, of whom 72.0% of participants were male; the median age was 53 years, and 164 participants (22.7%) were on at least one AC drug. Among these, 28.6% experienced at least one AC sign/symptom. Agreement in AC risk classification was substantial only between ARS and ADS (k = 0.6). Lower and higher risk of AC signs/symptoms was associated with dual regimens [adjusted OR (aOR) = 0.12 versus three-drug regimens, P = 0.002] and increasing number of AC drugs (aOR = 12.91, P < 0.001). Depression and COPD were also associated with higher risk of AC signs/symptoms in analysis unadjusted for number of AC drugs. ABS and ADS showed the best area under the ROC curve (AUROC) of 0.85 (0.78-0.92) and 0.84 (0.75-0.92; P < 0.001 for both). However, at the cut-off used for the general population, the sensitivity of all three scales was very low (34.0%, 46.8% and 46.8%).
conclusionsUp to one-fourth of participants in our cohort were exposed to at least one AC drug, and among them AC signs/symptoms affected more than one-fourth. Both polypharmacy (as number of antiretrovirals and of co-medications with AC properties) and to a lesser extent specific comorbidities shaped the risk of developing AC signs/symptoms. Sensitive screenings for AC risk in PWH should prefer ABS or ADS based on lower cut-offs than those suggested for the general population.
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