Lionel Lellouche1,2, Laure-Anne Gutierrez1, Pascale Leclercq3, Olivia Zaegel-Faucher4, Louis Bernard5, Matteo Vassallo6, Claudine Barbuat7, Anna Ozguler8, Marie Zins8, Laura Nailler9, Jacques Reynes10, Claudine Berr1, Alain Makinson10. 1. Institute for Neurosciences of Montpellier INM, University of Montpellier, Montpellier, France. 2. Epidemiology of Animal and Zoonotic Diseases Unit, INRAE (Institut National de Recherche pour l'Agriculture, l'alimentation et l'Environnement), Marcy L'étoile, France. 3. Infectious Disease Unit, University Hospital of Grenobles Alpes, and Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin, Université Grenoble Alpes, Grenoble, France. 4. Clinical Immuno-Hematology Department, Aix- Marseille University, Sainte-Marguerite University Hospital, Marseille, France. 5. Infectious Diseases Unit, University Hospital Tours, Tours, France. 6. Department of Internal Medicine, Cannes General Hospital, Cannes, France. 7. Infectious Diseases Department, University Hospital, Nîmes, France. 8. Paris Descartes University Population-based Epidemiological Cohorts Unit, INSERM, Villejuif, France. 9. Department of Clinical and Therapeutic Research on HIV and Hepatitis, ANRS (France Recherche Nord & Sud Sida-HIV Hépatites), Paris, France; and. 10. Infectious and Tropical Diseases Department, University Hospital Montpellier, Institut de Recherche et Développement, INSERMU1175, University of Montpellier, Montpellier, France.
Abstract
BACKGROUND: We compared the prevalence of frailty among aging people living with HIV (PLHIV) with people without HIV from the ANS EP58 HAND 55-70 Study. METHODS: Cross-sectional multicentric study which consecutively included 200 PLHIV and 1000 people without HIV from the French national CONSTANCES cohort, matched on age, sex, and education level. PLHIV were aged 55-70 years, with a HIV viral load < 50 copies/mL and a lymphocyte T-CD4 level > 200 cells/µL for the last 24 and 12 months, respectively. We measured frailty (>2 items) and prefrailty (one or 2 items) using a proxy of the 5-item Fried score. Multivariate logistic regression was performed to assess the association between HIV and frailty/prefrailty, adjusting for demographic, social, behavioral, and comorbidity confounders. RESULTS: Outcome measures were available for 192 PLHIV and 822 people without HIV. The median age was 62 years, and 84.9% were men. Among PLHIV, the median CD4 cell count was 645.5 cells/µL. Prevalence of frailty/prefrailty was 5.73%/57.3% in PLHIV vs. 1.73%/52.2% in people without HIV, respectively. HIV was associated with prefrailty/frailty [odds ratio = 1.89; 95% confidence interval = 1.37 to 2.61), but after adjusting for social and behavioral factors and comorbidities, HIV was not significantly associated with prefrailty/frailty (odds ratio = 1.24; 95% confidence interval: = 0.84 to 1.81). In PLHIV only, frailty/prefrailty was associated with depressive symptomatology, kidney disease, and time since HIV infection. CONCLUSIONS: Prevalence of frailty is increased in aging PLHIV with well-controlled HIV disease, but other factors than HIV are predominant, particularly depression and comorbidities.
BACKGROUND: We compared the prevalence of frailty among aging people living with HIV (PLHIV) with people without HIV from the ANS EP58 HAND 55-70 Study. METHODS: Cross-sectional multicentric study which consecutively included 200 PLHIV and 1000 people without HIV from the French national CONSTANCES cohort, matched on age, sex, and education level. PLHIV were aged 55-70 years, with a HIV viral load < 50 copies/mL and a lymphocyte T-CD4 level > 200 cells/µL for the last 24 and 12 months, respectively. We measured frailty (>2 items) and prefrailty (one or 2 items) using a proxy of the 5-item Fried score. Multivariate logistic regression was performed to assess the association between HIV and frailty/prefrailty, adjusting for demographic, social, behavioral, and comorbidity confounders. RESULTS: Outcome measures were available for 192 PLHIV and 822 people without HIV. The median age was 62 years, and 84.9% were men. Among PLHIV, the median CD4 cell count was 645.5 cells/µL. Prevalence of frailty/prefrailty was 5.73%/57.3% in PLHIV vs. 1.73%/52.2% in people without HIV, respectively. HIV was associated with prefrailty/frailty [odds ratio = 1.89; 95% confidence interval = 1.37 to 2.61), but after adjusting for social and behavioral factors and comorbidities, HIV was not significantly associated with prefrailty/frailty (odds ratio = 1.24; 95% confidence interval: = 0.84 to 1.81). In PLHIV only, frailty/prefrailty was associated with depressive symptomatology, kidney disease, and time since HIV infection. CONCLUSIONS: Prevalence of frailty is increased in aging PLHIV with well-controlled HIV disease, but other factors than HIV are predominant, particularly depression and comorbidities.