• the prevalence of comorbidities, multimorbidities, and frailty is higher in PLHIV than in the general population at all ages, and the gap between the two populations widens with age.
 
• Pooled results demonstrated that patients with HIV experiencing frailty were at an increased risk of all-cause mortality (pooled HR = 2.69, 95% CI = 1.83-3.97, p < .001) compared with those without frailty.
• These results have been confirmed in several original studies. Pelloquin et al. prospectively collected the electronic health records of 359 patients. At the 8-year follow-up, frailty/prefrailty, as assessed by the Fried frailty phenotype, was associated with an increased risk of all-cause mortality compared with nonfrail patients with HIV.18 In another study of 3,472 patients with HIV, multivariable models demonstrated that the aFRP and prefrailty were significantly associated with 75% and 44% increased risk for 5-year all-cause mortality, respectively.
• Therefore, more attention should be paid to screen patients with HIV for frailty and adopt appropriate interventions and personalized treatment plans to prevent the occurrence of adverse events.
• Furthermore, screening factors that increase the risk of frailty was helpful for preventing adverse outcomes in HIV patients. McMillan et al. demonstrated that HIV patients with hepatitis C virus coinfection, cirrhosis, metabolic syndrome, lung disease, and polypharmacy were associated with increased risk of frailty.35 In addition, hypothyroidism, arthritis, and tobacco use were associated with 2.55-, 2.54-, and 1.79-fold risk of frailty, respectively.36 Therefore, more attention should be paid to screening for frailty in HIV patients with comorbidities.
• Pelloquin et al. found that a 0.1 m/s decrease in gait speed in a 400-m walk test among patients with HIV was significantly associated with mortality, after adjusting for smoking, sex, or physical activity.18 Moreover, handgrip is a critical risk indicator of fractures in patients with HIV infection.32 In contrast, frailty is closely related to sarcopenia, which is characterized by loss of skeletal muscle and decreased physical function.33 de Almeida et al. included 101 patients with HIV, aged over 50 years, and found that 12% of patients had sarcopenia, as evaluated by DXA.34
• Meanwhile, patients with sarcopenia were associated with an increased risk of low hip bone mineral density and a high prevalence of morphometric vertebral fractures compared with those without sarcopenia.34