Frailty and prefrailty in people living with HIV, with focus on women living with HIV

Abstract

With the increasing lifespan of people living with HIV (PLWH), frailty and prefrailty are becoming topics which require more attention. The reciprocal interactions between chronic inflammation, comorbidities and frailty demonstrate the complex pathophysiology of frailty and its consequences. Female sex, HIV infection without antiretroviral treatment, reduced CD4 cell count, depression and cardiovascular disease are some of the risk factors for frailty among PLWH. Frailty predisposes to falls and can therefore lead to more frequent fractures, hospitalization and death, especially in women with osteoporosis. Continuous antiretroviral treatment, prevention of comorbidities such as depression and diagnosis of prefrailty are crucial interventions to slow the development of frailty. This review summarizes the literature on frailty in people living with HIV and discusses frailty management strategies in order to improve the health outcomes in women living with HIV.

Cardiometabolic Diseases and Quality-of-Life Outcomes in Adults With HIV in the Deep South: A Cross-sectional Study

“…As PLWH age, the presence of these CMDs may also increase risk of progression to frailty—another prevalent condition that may negatively affect HRQoL among PLWH (Mark Bloch, 2018; McMillan et al, 2019; Sangarlangkarn et al, 2022; Verheij et al, 2020). Functional impairments, including gait disorders, fall risk, acute illness, and fractures, that can affect successful aging and QoL outcomes for PLWH may result after the onset of frailty (Erlandson et al, 2019; Krankowska et al, 2022). Furthermore, the joint interaction between CMDs and frailty may also lead to disability and subsequent institutionalization, all of which may influence QoL (M.…”

“…With an increase in life expectancy, PLWH are faced with an excess burden of CMDs that can negatively affect functional independence and quality-of-life (QoL) outcomes (Althoff et al, 2019; Marcus et al, 2020). Additionally, other long-term consequences of CMDs such as frailty and disability accumulation are also crucial targets for present day prevention and interventions among PLWH (Fazeli et al, 2020; Harris et al, 2018; Krankowska et al, 2022; Lorenz et al, 2021). Notably, the socioeconomic consequences of managing these conditions also abound both at the individual and health system levels with varying degrees of loss of productivity and high demand for limited resources.…”