Yeoh Hui-Ling, Cheng Allen, Palmer Clovis, Crowe Suzanne M, Hoy Jennifer F
Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia.
Department of Infectious Diseases, Monash University, Melbourne, Australia.
Antivir Ther. 2018;23(2):117-127. doi: 10.3851/IMP3185.
Potent antiretroviral treatment has resulted in near normal life expectancy for people living with HIV. Consequently, there is an increased focus on comorbidities, frailty and quality of life.
We assessed and compared the prevalence of frailty, associated factors and relationship with quality of life in older Australian men living with HIV in a cross-sectional study using three frailty measurements. The Frailty Phenotype, Frailty Index and Edmonton Frail Scale were applied to 93 HIV-infected men aged over 50 years, on antiretroviral therapy. Multivariable ordinal logistic regression was used to analyse the associations of frailty with covariates and quality of life.
The prevalence of frailty was 10.8% (n=10) using the Frailty Phenotype; 22.6% (n=21) using the Frailty Index and 15.1% (n=14) using the Edmonton Frail Scale. Frailty Phenotype-defined pre-frailty/frailty was associated with pre-1996 ART initiation (OR, 3.56; CI, 1.23, 10.36; P=0.020) and depression (OR, 3.74; CI, 1.24, 11.27; P=0.019). Osteoporosis, serious non-AIDS events and AIDS were associated with Frailty Index-defined frailty (OR, 4.84, CI, 1.27, 18.43, P=0.021; OR, 4.27, CI, 1.25, 14.58, P=0.020; OR, 4.62, CI, 1.30, 16.45, P=0.018, respectively) and Edmonton Frail Scale-defined frailty (OR, 7.51; CI, 1.55, 36.42; P=0.012; OR, 7.71; CI, 1.62, 36.75; P=0.010; OR, 8.53; CI, 1.70, 42.73; P=0.009, respectively), independent of age and current CD4 T-cell count. Frailty, defined by any of the instruments, was significantly associated with poorer quality of life (P<0.001).
Identifying frailty is an increasingly important contemporary consideration of HIV care related to ageing and quality of life.
强效抗逆转录病毒治疗已使HIV感染者的预期寿命接近正常水平。因此，人们越来越关注合并症、身体虚弱和生活质量。
在一项横断面研究中，我们使用三种身体虚弱测量方法，评估并比较了澳大利亚老年HIV感染者中身体虚弱的患病率、相关因素及其与生活质量的关系。对93名年龄超过50岁、正在接受抗逆转录病毒治疗的HIV感染男性应用了衰弱表型、衰弱指数和埃德蒙顿衰弱量表。采用多变量有序逻辑回归分析身体虚弱与协变量及生活质量的关联。
使用衰弱表型时，身体虚弱的患病率为10.8%（n = 10）；使用衰弱指数时为22.6%（n = 21）；使用埃德蒙顿衰弱量表时为15.1%（n = 14）。衰弱表型定义的前期虚弱/虚弱与1996年前开始抗逆转录病毒治疗（比值比，3.56；可信区间，1.23，10.36；P = 0.020）和抑郁（比值比，3.74；可信区间，1.24，11.27；P = 小0.019）相关。骨质疏松症、严重非艾滋病事件和艾滋病与衰弱指数定义的虚弱（比值比分别为4.84，可信区间1.27，18.43，P = 0.021；比值比4.27，可信区间1.25，14.58，P = 0.020；比值比4.62，可信区间1.30，16.45，P = 0.018）和埃德蒙顿衰弱量表定义的虚弱（比值比分别为7.51；可信区间1.55，36.42；P = 0.012；比值比7.71；可信区间1.62，36.75；P = 0.010；比值比8.53；可信区间1.70，42.73；P = 0.009）相关，且独立于年龄和当前CD4 T细胞计数。任何一种工具定义的身体虚弱均与较差的生活质量显著相关（P < 0.001）。
识别身体虚弱是当代HIV护理中与衰老和生活质量相关的一个日益重要的考虑因素。
