Adverse clinical outcomes in older people living with HIV:

The aging of people living with HIV increases the risk of multimorbidity, functional impairment, and other geriatric syndromes. However, longitudinal studies evaluating these outcomes remain limited. The objective of this study is to compare adverse clinical outcomes between older adults living with HIV and older adults without HIV after 24 months of follow-up. A prospective cohort study was conducted with 110 individuals ≥60 years of age (54 living with HIV and 56 controls) followed between 2022 and 2024. Functional status, cognition, depressive symptoms, falls, hospitalizations, emergency visits, multimorbidity, polypharmacy, and mortality were assessed using validated instruments. Older adults living with HIV had a higher frequency of polypharmacy, drug interactions, and use of potentially inappropriate medications, as well as a worse functional trajectory. There were no significant differences between the groups in hospitalizations, falls, fractures, mortality, or incident cognitive impairment. The control group showed improved independence in instrumental activities of daily living and a reduction in visits to emergency services. Although HIV was not associated with an increase in major adverse clinical events, older adults living with HIV had a worse functional trajectory, reinforcing the need for multidisciplinary follow-up focused on maintaining functional capacity.