Document Detail


Frailty in HIV-infected adults in South Africa.
MedLine Citation:
PMID:  23018372     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Some evidence suggests that HIV infection is associated with premature frailty-a syndrome typically viewed as being related to ageing. We determined the prevalence and predictors of frailty in a population of HIV-infected individuals in South Africa.
DESIGN: Case-control study of 504 adults more than the age of 30 years, composed of 248 HIV-infected adults and 256 age- and gender-matched, frequency-matched HIV-seronegative individuals.
METHODS: Frailty was defined by standardized assessment comprised of ≥ 3 of weight loss, low physical activity, exhaustion, weak grip strength, and slow walking time. Independent predictors of frailty were evaluated using multivariable logistic regression.
RESULTS: The mean ages of the HIV-infected and HIV-seronegative groups were 41.1 ± 7.9 years and 42.6 ± 9.6 years, respectively. Of the HIV-infected adults, 87.1% were receiving antiretroviral treatment (median duration, 58 months), their median CD4 count was 468 cells/μL (interquartile range = 325-607 cells/μL) and 84.3% had undetectable plasma viral load. HIV-infected adults were more likely to be frail than HIV-seronegative individuals (19.4% vs. 13.3%; P = 0.07), and this association persisted after adjustment for confounding variables [adjusted OR = 2.14; 95% confidence interval (95% CI): 1.16-3.92, P = 0.01]. Among HIV-infected individuals, older age was a strong predictor of frailty, especially among women (women: OR = 2.55 per 10-year age increase; men: OR = 1.29 per 10-year age increase, P-interaction = 0.01). Lower current CD4 count (<500 cells/μL) was also independently associated with frailty (OR = 2.84; 95% CI: 1.02 -7.92, P = 0.04).
CONCLUSIONS: HIV infection is associated with premature development of frailty, especially in women. Since higher CD4 counts were associated with lower risk of frailty, earlier initiation of antiretroviral treatment may be protective.
Authors:
Sophia Pathai; Clare Gilbert; Helen A Weiss; Colin Cook; Robin Wood; Linda-Gail Bekker; Stephen D Lawn
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-02-26     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-51     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*
Adult
Age Distribution
Aged
CD4 Lymphocyte Count
Case-Control Studies
Female
Humans
Male
Middle Aged
Muscle Weakness / epidemiology*
Sex Factors
South Africa
Grant Support
ID/Acronym/Agency:
088590//Wellcome Trust; 088590//Wellcome Trust; 090354//Wellcome Trust; 090354/Z/09/Z//Wellcome Trust; G0700837//Medical Research Council
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