Frequency, Risk Factors, and Mediators of Frailty Transitions During Long-Term Follow-Up Among People With HIV and HIV-Negative AGEhIV Cohort Participants

Abstract

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Ageing with HIV: Challenges and biomarkers

“…In this respect, the AGEhiV cohort with PLWH and well-matched negative controls found that prevalence of frailty, as well as transition to frailty overtime was higher in PLWH than HIV-negative controls, and a long cumulative exposure to ddC increased the odds to become frail. 6 One of the oldest cohorts established to study ageing is the VACS (Veterans Ageing Cohort Study) (https:// medicine.yale.edu/intmed/vacs/). This cohort is one of the most extensively studied and has produced the VACS index to assess disease severity and mortality risk.…”

“…In this respect, the AGEhiV cohort with PLWH and well-matched negative controls found that prevalence of frailty, as well as transition to frailty overtime was higher in PLWH than HIV-negative controls, and a long cumulative exposure to ddC increased the odds to become frail. 6 …”

“…These include frailty and metabolic, cardiovascular, cancer, bone, and neurodegenerative disorders. 5 , 6 Even with successful ART, the difference in comorbidity-free years between PLWH and the general population persists. 2 This excess of morbidity suggests premature ageing in PLWH, both caused by the HIV infection itself and complex interaction of ART effects, chronic viral co-infections and lifestyle/behavioural factors.…”

Different profiles among older adults with HIV according to their chronological age and the year of HIV diagnosis: The FUNCFRAIL cohort study (GeSIDA 9817)

“…Physical frailty is a clinical syndrome defined by five criteria—shrinking, weakness, poor endurance and energy, slowness, and low physical activity level—in which the whole is more than the sum of the parts in terms of predicting adverse health outcomes [ 12 ]. Frailty is prevalent in the older adults with HIV, is associated with mortality and is potentially reversible [ 13 – 15 ].Frailty is starting to be proposed as a clinical marker of biological age [ 7 ].…”

HIV: the changing paradigm

“…The key health challenges faced by PLHIV now relate to chronic diseases thought to stem from a combination of factors including chronic immune activation, coinfections and drug toxicities. PLHIV are at increased risk of frailty compounded by risk factors, such as obesity, multiple comorbidities and depression, and experience an increased rate of hospitalisation compared to comparable HIV‐negative cohorts 70–72 . These factors have been associated with premature and accentuated ageing in PLHIV, and can lead to chronic diseases, such as cancer, cardiovascular, metabolic and neurocognitive disease 73 …”