title: Antiretroviral therapy protects against frailty in HIV-1 infection.
abstract: HIV-1-infected patients are surviving longer and by 2015 half will be older than 50 years of age. Frailty is a syndrome associated with advanced age but occurs in HIV-1-infected patients at younger ages. One hundred outpatient HIV-1-infected persons were prospectively tested for clinical markers of frailty: shrinking weight, slowness in walking, decrease in grip strength, low activity, and exhaustion. Age, length of infection with HIV, CD4 count, HIV-1 RNA, and comorbidities were compared. CD4 counts <200 cells/mm(3) were associated with 9-fold increased odds of frailty relative to patients with a CD4 count >350 cells/mm(3) (odds ratio [OR] 9.0, 95% confidence interval [CI] 2.1-44). Seven frail patients were measured 6 months later: 2 died refusing therapy, 4 were no longer frail, and 1 patient remained frail. We conclude that frailty is common in HIV outpatients and is associated with low CD4 counts. However, our data suggest that frailty is transient, especially in younger patients who may revert to their prefrail state unlike uninfected elderly individuals in whom a stepwise decline in function occurs.
authors.affiliation: Department of Medicine, University of Arizona, Tucson, AZ 85724, USA. skolz@u.arizona.edu
authors.forename: Voichita
authors.initials: V
authors.lastname: Ianas
authors.forename: Erik
authors.initials: E
authors.lastname: Berg
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Mohler
authors.forename: Christopher
authors.initials: C
authors.lastname: Wendel
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Klotz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000502:physiology; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology*; D015497:HIV-1; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology
chemical_list: D044966:Anti-Retroviral Agents