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Background: Standard care for HIV clinical practice has started focusing on age-related problems, but despite this recent change physicians involved in HIV care do not often screen HIV patients for frailty. Our aim was to construct three indexes from an HIV clinical database (i.e. Frailty Index, (FI), HIV Index, (HIVI), and Protective Index (PI)) and to assess levels of frailty, HIV severity and demographic and protective lifestyle factors among HIV patients.
Methods And Findings: We included data from 1612 patients who attended an Italian HIV clinic between September 2016 and December2017 (mean±SD age: 53.1±8 years, 73.9% men).We used 92 routine variables collected by physicians and other health care professionals to construct three indexes: a 72-item FI (biometric, psychiatric, blood test, daily life activities, geriatric syndromes and nutrition data), a 10-item HIVI (immunological, viral and therapeutics) and a 10-item PI (income, education, social engagement, and lifestyle habits data)(the lower the FI and HIVI scores, and the higher the PI scores, the lower the risk for participants).The FI, HIVI and PI scores were 0.19±0.08, 0.48±0.17 and 0.62±0.13, respectively. Men had higher FI (0.19±0.08 vs 0.18±0.08; p = 0.010) and lower HIVI (0.47±0.18 vs 0.50±0.15; p = 0.038) scores than women. FI and HIVI scores both increased 1.9% per year of age (p < 0.001), whereas the PI decreased 0.2% per year (p<0.050). In addition, the FI score increased 1.6% and the PI score decreased 0.5% per year of HIV infection (p < 0.001).
Conclusion: It is feasible to assess levels of frailty, HIV severity and protective lifestyle factors in HIV patients using data from a clinical database. Frailty levels are high among HIV patients and even higher among older patients and those with a long duration of HIV. Future studies need to examine the ability of the three indices to predict adverse health outcomes such as hospitalization and mortality.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192552 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201394 | PLOS |
BMC Infect Dis
December 2024
Department of Nursing Sciences, Faculty of Health Sciences & Technology, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria.
Background: Falls are a common problem experienced by people living with HIV yet predictive models specific to this population remain underdeveloped. We aimed to identify, assess and stratify the predictive strength of various physiological, behavioral, and HIV-specific factors associated with falls among people living with HIV and inform a predictive model for fall prevention.
Methods: Systematic review and meta-analysis were conducted to explore predictors of falls in people living with HIV.
Drugs Aging
December 2024
Department of Infectious Diseases, Alfred Hospital and Monash University, 55 Commercial Rd, Melbourne, VIC, 3004, Australia.
Owing to widespread availability of potent and tolerable antiretroviral therapy, life expectancy of people with human immunodeficiency virus (HIV) has significantly increased. Consequently, the population of people with HIV are ageing, with over 50% over the age of 50 years, and it is expected that 25% will be over the age of 65 years by 2030. People diagnosed with HIV at older age tend to have more advanced disease, and may already be experiencing comorbidities that will influence the choice of initial antiretroviral treatment.
View Article and Find Full Text PDFCurr HIV/AIDS Rep
December 2024
Department of Infectious Diseases, Alfred Hospital, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.
Purpose Of Review: Potent, well tolerated and simple to administer antiretroviral therapy (ART) has resulted in significant improvement in life expectancy for people with HIV. The increased lifespan does not necessarily equate to improved healthspan with increased rates of comorbidities, frailty and geriatric syndrome experienced by older people with HIV. This review explores the challenges in prevention and management of multimorbidity and geriatric syndrome with the ultimate goal of improving health and quality of life through holistic care.
View Article and Find Full Text PDFJ Infect Dis
December 2024
Amsterdam UMC, location University of Amsterdam, Department of Infectious Diseases, Meibergdreef 9, Amsterdam, The Netherlands.
Background: People with HIV (PWH) experience a higher burden of ageing-associated comorbidities, the underlying mechanisms of which remain to be fully elucidated. We aimed to identify profiles based on immune, inflammatory, and ageing biomarkers in blood from PWH and controls, and explore their association with total comorbidities over time.
Methods: Latent profile analysis was used to construct biomarker profiles in AGEhIV cohort participants (94 with well-controlled HIV on antiretroviral therapy (ART) and 95 controls without HIV) using baseline measurements of selected biomarkers.
PLoS One
December 2024
School of Medicine, University College Dublin, Dublin 4, Ireland.
Background: Effective antiretroviral therapy (ART) has improved the life expectancy of people with HIV (PWH). However, this population is now experiencing accelerated age-related comorbidities, contributed to by chronic immune activation and inflammation, with dysbiosis of the gut microbiome also implicated.
Method: We conducted a systematic literature search of PubMed, Embase, Scopus, Cochrane reviews and international conference abstracts for articles that examined for the following non-communicable diseases (NCDs); cardiovascular disease, cancer, frailty, metabolic, bone, renal and neurocognitive disease, in PWH aged >18 years.
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