Gender differences for frailty in HIV-infected patients on stable antiretroviral therapy and with an undetectable viral load

Autor: Inmaculada Barrio, Mercedes Sanz, Valvanera Ibarra, José A. Oteo, Enrique Ramalle-Gomara, Lucía Antón, Estrella Melús, José-Ramón Blanco, María Isabel Beltran, Luis Metola
Jazyk: angličtina
Rok vydání: 2019
Předmět:
RNA viruses
Male
Viral Diseases
Cross-sectional study
Physiology
HIV Infections
Pathology and Laboratory Medicine
Biochemistry
Endocrinology
Quality of life
Immunodeficiency Viruses
Risk Factors
Medicine and Health Sciences
Prevalence
Sex Characteristics
Multidisciplinary
Frailty
Middle Aged
Viral Load
C-Reactive Proteins
AIDS
Infectious Diseases
Phenotype
Treatment Outcome
Medical Microbiology
Viral Pathogens
Cohort
Viruses
Medicine
Female
Menopause
Pathogens
Viral load
Research Article
medicine.medical_specialty
Anti-HIV Agents
Science
Context (language use)
Microbiology
Acquired immunodeficiency syndrome (AIDS)
Internal medicine
Retroviruses
Mental Health and Psychiatry
medicine
Humans
Microbial Pathogens
Polypharmacy
Endocrine Physiology
business.industry
Lentivirus
Organisms
Biology and Life Sciences
HIV
Proteins
medicine.disease
Health Care
Regimen
Cross-Sectional Studies
Geriatrics
Quality of Life
business
Zdroj: PLoS ONE
PLoS ONE, Vol 14, Iss 5, p e0215764 (2019)
ISSN: 1932-6203
Popis: BackgroundPatients with HIV infection suffer from accelerated aging. In this context, frailty could be a relevant problem that aggravates the quality of life (QoL) and morbi-mortality of these patients. Our objective was to determine the prevalence of frailty and pre-frailty in HIV-infected patients in our cohort as well as their risk factors and QoL.MethodsThis was a prospective cross-sectional study of HIV-infected people aged ≥18 years on a stable antiretroviral regimen (ART) ≥1 year. Frailty was defined by ≥3 of 5 Fried's criteria: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Variables related to sociodemographics, HIV infection, comorbidities, polypharmacy, and QoL were evaluated. Independent predictors of frailty were evaluated using collinearity in a multivariate logistic regression analyses (backward stepwise elimination).ResultsThe 248 people studied has a mean age of 49 years, 63.7% were male, and 81% were Caucasian. The prevalence of pre-frailty and fragility was 39.1% and 4.4%, respectively. The main route of HIV acquisition was heterosexual (47.2%). At the inclusion time 26.6% of the patients had AIDS events, 60.9% were anti-HCV negative, and 91.5% had HIV RNA 2 comorbidities, and 13.3% were receiving >5 non-HIV drugs. Frailty patients had a higher age (p 0.006), more sensitive deficits (visual or auditory) (p 0.002), a greater number of falls during the previous year (p 0.0001), a higher Charlson comorbidity index (p 0.001), and a higher VACS index (p 0.001). All comorbidities, excluding bone and liver, were significantly more frequent in fragile patients. The presence of >2 comorbidities and treatment with >5 drugs not related to HIV they were also more frequent in frail patienst (p 0.0001 and p 0.004, respectively). Independent predictors of pre-frailty/frailty in the multivariable analysis differ in men (VACS index, C-reactive protein [CRP], and falls) and women (CRP, AIDS, and menopause). Patients with pre-frailty/frailty had some indicator of a lower QoL.ConclusionFactors associated with pre-frailty/frailty in HIV-infected patients differ by gender, which should be considered when establishing measures for prevention. The role of menopause in the risk of pre-frailty/frailty warrants further investigations.
Databáze: OpenAIRE
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