Risk of Falls in HIV-Infected Patients on Antiretroviral Therapy and Its Associated Factors

Abstract

Purpose Fall is one of the geriatric syndromes and a significant public health concern, which causes potentially severe consequences among the elderly. Geriatric syndromes are common among PLHIV and affect younger age than the general population. This study attempted to identify the risk of falls in PLHIV on antiretroviral therapy (ART) and its related factors among older adults with HIV infection. Methods This cross-sectional study was conducted from December 2019 to May 2020 among PLHIV aged ≥40 years who received ART for at least 6 months in HIV Integrated Clinic, Cipto Mangunkusumo Hospital, Jakarta. Bivariate and multivariate analyses were performed using Poisson regression with robust estimator using STATA version 12.0. Results A total of 102 participants mainly consisted of males (83.3%) with a median age of 45 (IQR 5) years. The risk of fall was detected in 52% of these participants. PLHIV who have history of falls, current CD4 below 200 cells/mm 3 , and pre-frail–frail status were associated with an increased risk of falls in the future. An LPV/r-based regimen was found to be a protective factors of risk of falls among PLHIV. Conclusion History of falls, current CD4 below 200 cells/mm 3 , and pre-frail and frail status were identified as factors associated with a greater risk of fall among PLHIV.

The Impact of Number of Medications on Falls in Aging Persons with Human Immunodeficiency Virus

“…It should also be noted that the start of our study period was 2012, and newer antiretroviral regimens approved since the start of the study period in general may have improved safety profiles, including in older PWH. Second, the study design did not allow for the quantitative capture of measures such as frailty, neuropathy, or other physical factors that are associated with fall risk, as previous studies have identified frailty as well as imbalance symptoms as being associated with an increased risk of falls in PWH [ 22 , 30 ]. The study was conducted at only one site, and although the demographics are similar to many inter-city HIV clinics, this limits the generalizability of the results.…”

Polypharmacy Is Associated With Slow Gait Speed and Recurrent Falls in Older People With HIV

“…Prior studies reported an increased risk for falls among PWH compared with the general population, with PWH experiencing falls at a younger age compared with adults without HIV [ 38 ]. Our results indicate that polypharmacy and hyperpolypharmacy, in particular, are strongly associated with a higher risk for recurrent falls among PWH.…”