{"doi":"10.1093/jac/dkad348","title":"Use of different anticholinergic scales and their correlation with anticholinergic symptom burden in a cohort of people living with HIV","abstract":"OBJECTIVES: How 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. METHODS: We 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. RESULTS: We 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%). CONCLUSIONS: Up 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.","journal":"Journal of Antimicrobial Chemotherapy","year":2023,"id":351979,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8185,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1097058,"name":"Mattia Trunfio","orcid":"0000-0001-8663-719X","position":1,"is_corresponding":false},{"id":1097059,"name":"Alessandra Coin","orcid":"0000-0003-1687-4493","position":2,"is_corresponding":false},{"id":1097517,"name":"Lolita Sasset","orcid":null,"position":3,"is_corresponding":false},{"id":1097060,"name":"Jacopo Farina","orcid":"0009-0003-9198-2600","position":4,"is_corresponding":false},{"id":1097518,"name":"Monica Brundu","orcid":null,"position":5,"is_corresponding":false},{"id":1097061,"name":"Vincenzo Scaglione","orcid":"0000-0002-2911-2255","position":6,"is_corresponding":false},{"id":1097062,"name":"Maria Devita","orcid":"0000-0001-5899-8000","position":7,"is_corresponding":false},{"id":1097063,"name":"Giuseppe Sergi","orcid":"0000-0001-9757-856X","position":8,"is_corresponding":false},{"id":1097064,"name":"Anna Maria Cattelan","orcid":"0000-0003-2869-2945","position":9,"is_corresponding":false},{"id":554597,"name":"Maria Mazzitelli","orcid":"0000-0003-0263-0703","position":0,"is_corresponding":true}],"reference_count":65,"raw_metadata":null,"created_at":"2026-07-19T01:12:45.897709Z","pmid":"37965917","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}