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Published in: Current HIV/AIDS Reports 3/2020

01-06-2020 | Human Immunodeficiency Virus | HIV Pathogenesis and Treatment (AL Landay and NS Utay, Section Editors)

Frailty in People Living with HIV

Author: Julian Falutz

Published in: Current HIV/AIDS Reports | Issue 3/2020

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Abstract

Purpose of Review

Different factors contribute to the decreased overall long-term survival in treated people living with HIV (PLWH). This paper will review the state of physical frailty which limits successful aging in PLWH.

Recent Findings

Identifiable events on the continuum from clinical normality to heightened risk of adverse health outcomes contribute to frailty. These center on chronic inflammation leading to destabilization of autoregulated physiologic systems challenged by environmental and biologic challenges. Frailty assessment can inform the profile of aging PLWH at increased risk of common age-related disorders and geriatric syndromes. Biologic and psychosocial risk factors promoting progression to and reversion from a dynamic state of frailty are being investigated, allowing for preventative interventions to be considered.

Summary

Insights gained from studying frail PLWH will help adapt an interdisciplinary geriatric model of health care for selected PLWH. This will improve the health and well-being of aging PLWH.
Literature
5.
go back to reference Centers for Disease Control and Prevention. HIV Surveillance Report, 25, . 2013 Published Feb 2015. Centers for Disease Control and Prevention. HIV Surveillance Report, 25, . 2013 Published Feb 2015.
11.
go back to reference •• Pathai S, Bajillan H, Landay AL, High KP. Is HIV a model of accelerated or accentuated aging? J Gerontol A Biol Sci Med Sci. 2014;69(7):833–42. https://doi.org/10.1093/gerona/glt168. This article introduces the key concepts of accelerated and accentuated aging in regards to the changing clinical profile of PLWH.CrossRefPubMed •• Pathai S, Bajillan H, Landay AL, High KP. Is HIV a model of accelerated or accentuated aging? J Gerontol A Biol Sci Med Sci. 2014;69(7):833–42. https://​doi.​org/​10.​1093/​gerona/​glt168. This article introduces the key concepts of accelerated and accentuated aging in regards to the changing clinical profile of PLWH.CrossRefPubMed
14.
go back to reference • De Francesco D, Wit FW, Burkle A, Oehlke S, Kootstra NA, Winston A, et al. Do people living with HIV experience greater age advancement than their HIV-negative counterparts? AIDS. 2019;33(2):259–68. https://doi.org/10.1097/QAD.0000000000002063. This paper investigates the important issue of differentiating chronologic and biologic age in PLWH using a multifactorial metric being validated in the general geriatric population.CrossRefPubMed • De Francesco D, Wit FW, Burkle A, Oehlke S, Kootstra NA, Winston A, et al. Do people living with HIV experience greater age advancement than their HIV-negative counterparts? AIDS. 2019;33(2):259–68. https://​doi.​org/​10.​1097/​QAD.​0000000000002063​. This paper investigates the important issue of differentiating chronologic and biologic age in PLWH using a multifactorial metric being validated in the general geriatric population.CrossRefPubMed
24.
33.
go back to reference • Vermeiren S, Vella-Azzopardi R, Beckwee D, Habbig AK, Scafoglieri A, Jansen B, et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016;17(12):1163 e1–e17. https://doi.org/10.1016/j.jamda.2016.09.010. This paper reviews the evidence supporting the clinical consequences of both prefrail and frail states.CrossRef • Vermeiren S, Vella-Azzopardi R, Beckwee D, Habbig AK, Scafoglieri A, Jansen B, et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016;17(12):1163 e1–e17. https://​doi.​org/​10.​1016/​j.​jamda.​2016.​09.​010. This paper reviews the evidence supporting the clinical consequences of both prefrail and frail states.CrossRef
43.
go back to reference •• Franceschi C, Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci. 2014;69(Suppl 1):S4–9. https://doi.org/10.1093/gerona/glu057. This paper presents the data supporting the role of chronic inflammation as a driver for age-related conditions.CrossRefPubMed •• Franceschi C, Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci. 2014;69(Suppl 1):S4–9. https://​doi.​org/​10.​1093/​gerona/​glu057. This paper presents the data supporting the role of chronic inflammation as a driver for age-related conditions.CrossRefPubMed
54.
go back to reference • Bakal DR, Coelho LE, Luz PM, Clark JL, De Boni RB, Cardoso SW, et al. Obesity following ART initiation is common and influenced by both traditional and HIV−/ART-specific risk factors. J Antimicrob Chemother. 2018;73(8):2177–85. https://doi.org/10.1093/jac/dky145. This paper supports the growing concern about the association of currently recommended antiretroviral drugs and increased weight.CrossRefPubMedPubMedCentral • Bakal DR, Coelho LE, Luz PM, Clark JL, De Boni RB, Cardoso SW, et al. Obesity following ART initiation is common and influenced by both traditional and HIV−/ART-specific risk factors. J Antimicrob Chemother. 2018;73(8):2177–85. https://​doi.​org/​10.​1093/​jac/​dky145. This paper supports the growing concern about the association of currently recommended antiretroviral drugs and increased weight.CrossRefPubMedPubMedCentral
55.
59.
go back to reference • Serrano-Villar S, Sainz T, Lee SA, Hunt PW, Sinclair E, Shacklett BL, et al. HIV-infected individuals with low CD4/CD8 ratio despite effective antiretroviral therapy exhibit altered T cell subsets, heightened CD8+ T cell activation, and increased risk of non-AIDS morbidity and mortality. PLoS Pathog. 2014;10(5):e1004078. https://doi.org/10.1371/journal.ppat.1004078. This paper provides evidence that persistent immune dysregulation in PLWH despite effective cART is a risk factor for adverse health events.CrossRefPubMedPubMedCentral • Serrano-Villar S, Sainz T, Lee SA, Hunt PW, Sinclair E, Shacklett BL, et al. HIV-infected individuals with low CD4/CD8 ratio despite effective antiretroviral therapy exhibit altered T cell subsets, heightened CD8+ T cell activation, and increased risk of non-AIDS morbidity and mortality. PLoS Pathog. 2014;10(5):e1004078. https://​doi.​org/​10.​1371/​journal.​ppat.​1004078. This paper provides evidence that persistent immune dysregulation in PLWH despite effective cART is a risk factor for adverse health events.CrossRefPubMedPubMedCentral
71.
go back to reference • Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK biobank participants. Lancet Public Health. 2018;3(7):e323–e32. https://doi.org/10.1016/S2468-2667(18)30091-4. This paper provides evidence that frailty is not limited to the geriatric population.CrossRefPubMedPubMedCentral • Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK biobank participants. Lancet Public Health. 2018;3(7):e323–e32. https://​doi.​org/​10.​1016/​S2468-2667(18)30091-4. This paper provides evidence that frailty is not limited to the geriatric population.CrossRefPubMedPubMedCentral
80.
109.
113.
go back to reference Branas F, Ryan P, Troya J, Sanchez-Conde M. Geriatric-HIV Medicine: the geriatrician’s role. Eur Geriatr Med. 2019;10(2):259–65 doi-prg-443.webvpn.fjmu.edu.cn/10.1007/s41999-018-0144-1.CrossRefPubMed Branas F, Ryan P, Troya J, Sanchez-Conde M. Geriatric-HIV Medicine: the geriatrician’s role. Eur Geriatr Med. 2019;10(2):259–65 doi-prg-443.webvpn.fjmu.edu.cn/10.1007/s41999-018-0144-1.CrossRefPubMed
114.
go back to reference • Pilotto A, Cella A, Pilotto A, Daragjati J, Veronese N, Musacchio C, et al. Three Decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc. 2017;18(2):192 e1–e11. https://doi.org/10.1016/j.jamda.2016.11.004. This paper summarizes the evidence supporting the fundamental assessment and intervention tool employed by geriatricians.CrossRef • Pilotto A, Cella A, Pilotto A, Daragjati J, Veronese N, Musacchio C, et al. Three Decades of comprehensive geriatric assessment: evidence coming from different healthcare settings and specific clinical conditions. J Am Med Dir Assoc. 2017;18(2):192 e1–e11. https://​doi.​org/​10.​1016/​j.​jamda.​2016.​11.​004. This paper summarizes the evidence supporting the fundamental assessment and intervention tool employed by geriatricians.CrossRef
128.
go back to reference • Woo J. Frailty, successful aging, resilience, and intrinsic capacity: a cross-disciplinary discourse of the aging process. Curr Geriatr Rep. 2019;8:67–71. https://doi.org/10.1007/s13670-019-0276-2. This paper introduces current models to consider factors related to successful aging of the growing population of the elderly world-wide.CrossRef • Woo J. Frailty, successful aging, resilience, and intrinsic capacity: a cross-disciplinary discourse of the aging process. Curr Geriatr Rep. 2019;8:67–71. https://​doi.​org/​10.​1007/​s13670-019-0276-2. This paper introduces current models to consider factors related to successful aging of the growing population of the elderly world-wide.CrossRef
Metadata
Title
Frailty in People Living with HIV
Author
Julian Falutz
Publication date
01-06-2020
Publisher
Springer US
Published in
Current HIV/AIDS Reports / Issue 3/2020
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-020-00494-2

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