 |
|
|
| |
One-year frailty transitions among persons living with HIV aged 70 years or more on ART
|
| |
| |
ABSTRACT
purpose
People living with HIV are ageing. Frailty is an age-related dynamic condition characterized by vulnerability to stressors, and is a predictor of adverse outcomes (falls, hospitalization, mortality). We assessed the frequency and factors associated with frailty transitions at one-year follow-up of treated PLWH aged 70 years or older (PLWH 70+) included in the French multicenter ANRS EP66 SEPTAVIH study cohort.
method
508 PLWH 70+, on antiretroviral treatment (ART) for at least 12 months, were included in the SEPTAVIH study between 05/2019 to 03/2020. Baseline data on socio-demographic characteristics, HIV infection and comorbidities were collected. Fried frailty phenotype was assessed at baseline and at 12 months (M12). Participants were classified as robust, prefrail or frail accordingly. Logistic regression models were used to evaluate factors associated with transition between frailty states. Models were adjusted for gender, socio-economic status, birthplace (sub-Saharan Africa vs. other) and period of HIV diagnosis (before vs. after 01/1996). We performed multiple imputations for missing data.
results
491 PLWH 70+ were analyzed, 17 died before M12 and were excluded. Participants' characteristics are presented in table and prevalence of frailty status at baseline and M12 in Figure 1. % for categorical variables, and median [interquartile range] for continuous variables Study population (n = 491) Male, n (%) 399 (81.3) Age (years) 73.6 [71.6 ; 77.0] Deprived socioeconomic status (EPICES score), n (%) 162 (33.0) Born in sub-saharan Africa, n (%) 32 (6.5) Duration of known HIV infection (years) 22.7 [15.5 ; 27.8] Duration of ART (years) 19.5 [12.2 ; 23.6] History of clinical AIDS, n (%) 135 (27.5) Nadir CD4 count (cells/mm3) 177 [70 ; 299] Baseline CD4 count (cells/mm3) 562 [418 ; 751] HIV viral load <><350 cells/mm3) and diabetes were significantly associated with transition from prefrailty to frailty: adjusted odds ratio (aor) 3.57, [95% confidence interval (ci): 1.27, 10.10], and 3.16 [1.20, 8.30], respectively. less than 3 comorbidities was associated with improvement from prefrailty to robustness, aor 2.08 [1.03, 4.35].>
conclusions
Frailty status worsened in 16% of PLWH 70+ over a short period of time. Low baseline CD4 and a high number of comorbidities were risk factors for progression, underscoring the importance of early HIV diagnosis and high ART adherence, and management of modifiable comorbidities.
|
| |
|
|
|
|
|
