Frailty in HIV infected people

Brégigeon, Sylvie; Galinier, Anne; Zaegel-Faucher, Olivia; Cano, Carla E.; Obry, Véronique; Laroche, Hélène; Trijau, S.; Saout, A.; Poizot‐Martin, Isabelle

doi:10.1097/qad.0000000000001507

Cited by 17 publications

(5 citation statements)

References 13 publications

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“…Among the few studies stratified by sex [13,14,16,17], only Blanco et al [17] detected differences in frailty predictors between men and women living with HIV. Specifically, they found that the increased level of C-reactive protein was a predictor of frailty and prefrailty for both sexes, but with an odds ratio almost three times higher in women than in men [17].…”

Section: Discussionmentioning

confidence: 99%

“…Considering the differences between men and women in terms of body composition, physiology of ageing, prevalence and clinical course of comorbidities, self-care and use of health services, it is reasonable to consider that the factors associated with frailty differ between men and women [15]. Up to now, the results of the few studies exploring possible sex differences in frailty and prefrailty in PLHIV reported have been mixed [13,14,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Frailty in people 50 years or older living with HIV: A sex perspective

Wiechmann,

Tejo,

Inácio

et al. 2023

HIV Medicine

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ObjectiveTo estimate prefrailty and frailty prevalence and associated factors in people living with HIV (PLHIV) from a sex perspective.MethodsCross‐sectional study on PLHIV at specialized public health centres in Brazil. Data were obtained from individuals aged ≥50 years using antiretroviral therapy (ART) and with an undetectable viral load through personal interviews, clinical evaluations and medical records. Frailty and prefrailty were characterized using the Fried Frailty Phenotype tool. Multinomial regression models were performed, and the associated factors were selected through the backward stepwise method.ResultsAmong 670 patients, 373 men and 297 women were included. The prevalence of frailty and prefrailty was significantly higher for women (16.2% and 56.2%, respectively) than for men (11.5% and 46.4%, respectively). Low socioeconomic and educational level, multimorbidity, depression, subjective cognitive complaints, and low scores on the Mini‐Mental State Exam (MMSE) were associated (P < 0.05) with frailty for both sexes. However, in the sex‐specific analysis, while smoking (OR = 3.66, 95% CI: 1.58–8.48) and a history of low adherence to ART (OR = 3.10, 95% CI: 1.33–7.23) were associated with frailty in men, depression (OR = 3.39, 95% CI: 1.36– 8.44) and the absence of functional dentition (OR = 3.77, 95% CI: 1.36– 10.43) were associated with frailty in women.ConclusionsThis study adds self‐reported cognitive complaints as a potential predictor of frailty in both sexes and supports the known deleterious effect of multimorbidity on frailty in adults living with HIV. Furthermore, it suggests that other possible predictors, such as depression, oral health status and adherence to ART, may be sex‐specific.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frailty in people 50 years or older living with HIV: A sex perspective

Wiechmann,

Tejo,

Inácio

et al. 2023

HIV Medicine

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“…Identification of frailty in older adults is important for guiding patient-centered care because these individuals may benefit from interventions such as comprehensive geriatric assessment, medication review, multidisciplinary team care, screening for common associated conditions or complications of frailty including cognitive impairment, and advance care planning. 5–14…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Identification of frailty can also help optimize patient-centered interventions such as a comprehensive geriatric assessment, medication review, multidisciplinary team care, screening for conditions and complications associated with frailty, and advance care planning. [5][6][7][8][9][10][11][12][13][14] The frailty phenotype (FP) and the frailty index (FI) are the two most commonly used measures of frailty, and both are reported to correlate well in PWH with cognitive function. 15,16 With the FP, frailty is deemed present when three or more of the clinical features of unintentional weight loss, slow walking speed, weak grip strength, low physical activity, and self-reported exhaustion are reported.…”

Section: Introductionmentioning

confidence: 99%

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Construct and Criterion-Related Validity of the Clinical Frailty Scale in Persons With HIV

McMillan

Gill

Power

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Diagnosis, prevention, and treatment of bone fragility in people living with HIV: a position statement from the Swiss Association against Osteoporosis

et al. 2019

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Life expectancy of people living with HIV (PLWH) is reaching similar length as in the general population. Accordingly, age-related comorbidities, including osteoporosis, are increasing. Fracture risk is higher and increases approximately 10 years earlier in PLWH. Classical risk factors of bone fragility are highly prevalent in PLWH but factors specific for HIV infection itself and the type of antiretroviral therapy (ART) (triple combination antiretroviral therapy) regimen (especially tenofovir and protease inhibitors) also contribute to bone loss. The majority of bone loss occurs during virus activity and at initiation of ART (immune reconstitution) and is associated with an increase of bone resorption (upregulation RANKL). Recent data indicate that calcium and vitamin D supplements as ART initiation lower BMD loss. The reduction of tenofovir plasma concentrations with tenofovir alafenamide attenuates BMD loss but it remains unknown whether it will contribute to reduce fracture risk. Hence, special considerations for the management of bone fragility in PLWH are warranted. Based on the current state of epidemiology and pathophysiology of osteoporosis in PLWH, we provide the consensus of the Swiss Association against Osteoporosis on best practice for diagnosis, prevention, and management of osteoporosis in this population. Periodic assessment of fracture risk is indicated in all HIV patients and general preventive measures should be implemented. All postmenopausal women, men above 50 years of age, and patients with other clinical risk for fragility fractures qualify for BMD measurement. An algorithm clarifies when treatment with bisphosphonates and review of ART regimen in favour of more bone-friendly options are indicated.

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Frailty in HIV infected people

Abstract: Our study shows that frailty according to SOF criteria is associated with low spinal BMD values in female and osteoporosis in male HIV-infected patients.

Cited by 17 publications

References 13 publications

Frailty in people 50 years or older living with HIV: A sex perspective

Frailty in people 50 years or older living with HIV: A sex perspective

Construct and Criterion-Related Validity of the Clinical Frailty Scale in Persons With HIV

Diagnosis, prevention, and treatment of bone fragility in people living with HIV: a position statement from the Swiss Association against Osteoporosis

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