Understanding Frailty, Aging, and Inflammation in HIV Infection

Abstract

Frailty is a clinical syndrome initially characterized in geriatric populations with a hallmark of age-related declines in physiologic reserve and function and increased vulnerability to adverse health outcomes. Recently, frailty has increasingly been recognized as a common and important HIV-associated non-AIDS (HANA) condition. This article provides an overview of our current understanding of frailty and its phenotypic characteristics, and evidence that they are related to aging and to chronic inflammation that is associated with aging and also with long-term treated HIV infection. The etiology of this chronic inflammation is unknown but we discuss evidence linking it to persistent infection with cytomegalovirus in both geriatric populations and people living with HIV infection.

Systematic Review of Prevalence and Predictors of Frailty in Individuals with Human Immunodeficiency Virus

“…There are some similarities in that prevalence appears to increase with age and pathophysiological mechanisms may overlap. Recent attention has fallen on the role of inflammation as a driver of or trigger for frailty states through multisystem degradation . Inflammatory profiles appear similar in those with and without HIV .…”

Hemostasis in elderly patients with human immunodeficiency virus (HIV) infection—Cross-sectional study

“…Markers of biological and cellular aging are common in HIV-reactive patients [21]. They affect lymphocytes and monocytes, increase inflammatory proteins and, when activated by the inflammatory response, express in their cytoplasmic membranes the Tissue Factor (TF), initiating coagulation [22][23][24][25][26].Studies started before and after ART, when compared to others in the geriatric area, confirm the common pre-thrombotic state among the two groups [27,28]. This pre-thrombotic state is usually associated with comorbidities and severity of infection [29], making the association a risk factor for mortality and for the survival rate of these patients not yet the same as the general population [10,24,[30][31][32][33].…”

Віл-Інфекція І Старіння: Нова Проблема В Еру Ефективної Антиретровірусної Терапії

“…У пацієнтів з ВІЛ-інфекцією відбувається підсилення хронічної імунної активації, що відображається у підвищених рівнях ІЛ-6 та ФНП-α, навіть якщо вони отримують АРТ. Це свідчить про те, що люди, які живуть з ВІЛ, зазнають передчасного або прискореного старіння [19].…”