HIV-ASSOCIATED CO-MORBIDITIES: Edited by Morris Schambelan and Todd T. BrownFrailty: the current challenge for aging people with HIVFalutz, Juliana; Brañas, Fátimab; Erlandson, Kristine M.cAuthor Information aDivision of Geriatric Medicine, Comprehensive HIV Aging Initiative, Combined Viral Illness Service, Division of Infectious Diseases, McGill University Health Center, Quebec, Canada bDivision of Geriatrics, Hospital Universitario Infanta Leonor, Madrid, Spain cDivisions of Infectious Diseases and Geriatric Medicine, University of Colorado Denver-Anschutz Medical Campus, Aurora, Colorado, USA Correspondence to Julian Falutz, Combined Viral Illness Service, McGill University Health Center, Room D02.4110, 1001 Decarie Boulevard Montreal, Quebec, Canada H4A-3J1. Tel: +1 514 934 8095; e-mail: [email protected] Current Opinion in HIV and AIDS: May 2021 - Volume 16 - Issue 3 - p 133-140 doi: 10.1097/COH.0000000000000677 Buy Metrics Abstract Purpose of review Older adults account for the majority of people with HIV (PWH) in high-income countries and have increasingly complex clinical profiles related to premature aging. Frailty is an important geriatric syndrome affecting a minority of PHW. Frailty negatively affects PHW's clinical status and quality of life. This review will update care providers on the current state of frailty that limits the healthspan of PWH. Recent findings Ongoing low-level HIV replication in treated PWH leads to immune activation and chronic inflammation contributing to the destabilization of normally autoregulated physiologic systems in response to environmental and biologic challenges characteristic of frailty. Understanding these underlying mechanisms will determine potential intervention options. Potentially reversible risk factors that promote progression to and reversion from the dynamic state of frailty are being studied and will help prevent frailty. Simple assessment tools and treatment strategies for frailty are being adapted for aging PWH. Summary Insight into underlying biologic mechanisms and adapting proven geriatric principles of interdisciplinary care will inform the healthy aging of PWH. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.