CLINICAL SCIENCE

HIV infection is independently associated with frailty in middle-aged HIV type 1-infected individuals compared with similar but uninfected controls

Kooij, Katherine W.; Wit, Ferdinand W.N.M.; Schouten, Judith; van der Valk, Marc; Godfried, Mieke H.; Stolte, Ineke G.; Prins, Maria; Falutz, Julian; Reiss, Peter on behalf of the AGEhIV Cohort Study Group

Author Information

aDepartment of Global Health, Academic Medical Center and Amsterdam Institute for Global Health and Development

bDivision of Infectious Diseases and Center for Infection and Immunity Amsterdam (CINIMA)

cDepartment of Neurology, Academic Medical Center

dDepartment of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands

eDivision of Medicine, McGill University Hospital Center, Montreal, Canada

fHIV Monitoring Foundation, Amsterdam, The Netherlands.

Correspondence to Katherine W. Kooij, MD, Amsterdam Institute for Global Health and Development, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. Tel: +31 20 5663349; e-mail: [email protected]

Received 22 June, 2015

Revised 10 September, 2015

Accepted 10 September, 2015

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.AIDSonline.com).

AIDS 30(2):p 241-250, January 2016. | DOI: 10.1097/QAD.0000000000000910

Abstract

Background: 

Frailty is an age-related syndrome of decreased physiological reserve and resistance to stressors, associated with increased morbidity and mortality in the general elderly population. An increased prevalence of frailty has been reported amongst HIV-infected individuals.

Methods: 

Fried frailty phenotype was systematically assessed in predominantly virologically suppressed HIV type 1 (HIV-1)-infected and otherwise comparable HIV-uninfected participants aged at least 45 at enrollment into the AGEhIV Cohort Study. Multivariable ordinal logistic regression was used to investigate associations between HIV- and antiretroviral therapy-related covariates, markers of inflammation and body composition and prefrailty/frailty.

Results 

: Data were available for 521 HIV-infected and 513 HIV-uninfected individuals. Prevalence of frailty (10.6 versus 2.7%) and prefrailty (50.7 versus 36.3%) were significantly higher in HIV-infected individuals (Ptrend < 0.001). HIV infection remained statistically significantly associated with prefrailty/frailty after adjustment for age, sex, race/ethnicity, smoking, hepatitis C infection, comorbidities and depression [adjusted odds ratio (ORadj) 2.16, P < 0.001]. A higher waist-to-hip ratio attenuated the coefficient of HIV-infected status (ORadj 1.93, P < 0.001), but not waist- or hip-circumference individually or markers of inflammation. Within the HIV-infected group, parameters related to body composition were most strongly and independently associated with prefrailty/frailty: current BMI less than 20 kg/m2 (OR 2.83, P < 0.001), nadir BMI less than 20 kg/m2 (OR 2.51, P < 0.001) and waist-to-hip ratio (OR 1.79 per 0.1 higher, P < 0.001).

Conclusion: 

HIV infection was independently associated with prefrailty/frailty in middle-aged HIV-infected patients compared with HIV-uninfected controls. This partly may be mediated by the higher waist- and lower hip-circumference in the HIV-infected individuals, potentially partially caused by lipodystrophy, and in part be a consequence of historic weight loss associated with advanced HIV-disease.

Erratum

There is a contradiction between the P values reported in the abstract and those reported in the manuscript text of this article by Kooij et al. . The P values reported in the results section of the manuscript are correct. In the abstract the P value for current BMI less than less than 20 kg/m2 should be P = 0.01 and not P < 0.001, and for nadir BMI less than 20 kg/m2 should be P = 0.001 and not P < 0.001).

The corrected abstract text should have read: “Within the HIV-infected group, parameters related to body composition were most strongly and independently associated with prefrailty/frailty: current BMI less than 20 kg/m2 (OR 2.83, P = 0.01), nadir BMI less than 20 kg/m2 (OR 2.51, P = 0.001) and waist-to-hip ratio (OR 1.79 per 0.1 higher, P < 0.001).”

AIDS. 30(11):1863, July 17, 2016.

Copyright © 2016 Wolters Kluwer Health, Inc.

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