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印度尼西亚接受抗逆转录病毒治疗的HIV-1感染成人中的衰弱情况。

Frailty among HIV-1 Infected Adults under Antiretroviral Therapy in Indonesia.

作者信息

Wulunggono Wulunggono, Yunihastuti Evy, Shatri Hamzah, Wahyudi Edy Rizal, Ophinni Youdiil

机构信息

Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.

Department of Pathology, Graduate School of Medicine, Kobe University, Kobe, Japan.

出版信息

Curr HIV Res. 2019;17(3):204-213. doi: 10.2174/1570162X17666190828143947.

Abstract

BACKGROUND

Increasing age of HIV-1 infected population brought about the risk of frailty as comorbidity, whose prevalence is higher in low and middle-income countries (LMICs). Indonesia as an LMIC also bears a major burden of HIV-1 epidemic with a similarly aging population, but the prevalence of frailty and its predictors are unknown.

OBJECTIVES

To identify the prevalence of frailty and analyze its associated factors, among HIV-1 infected adults under antiretroviral therapy in Indonesia.

METHODS

A cross-sectional study was conducted among HIV-infected individuals with inclusion criteria of age ≥30 years old and underwent ART for at least 6 months. The main assessment was done using Fried's frailty phenotype score, which categorizes subjects into non-frail, pre-frail, or frail. Factors associated with frailty were characterized and multiple logistic regression analysis was performed.

RESULTS

A total of 164 subjects were recruited; male subjects were 118 (72%), the median age was 40.5 years old, and the median CD4 nadir was 53 cells/μl. Frailty was identified among 90 (54.9%) subjects with 84 (51.2%) identified as pre-frail and 6 (3.7%) as frail, with dominant frailty phenotype was weakness in grip strength. The multivariate model showed that depression was the only factor significantly correlated with pre-frailty and frailty (OR 2.14; 95% CI 1.04-4.43, p=0.036).

CONCLUSION

Frailty is a common occurrence among HIV-infected patients under ART, with depression as an independent predictive factor.

摘要

背景

HIV-1感染人群年龄的增长带来了虚弱的风险,这与合并症有关,在低收入和中等收入国家(LMICs)中其患病率更高。印度尼西亚作为一个低收入和中等收入国家,也承受着HIV-1流行的重大负担,其人口同样老龄化,但虚弱的患病率及其预测因素尚不清楚。

目的

确定印度尼西亚接受抗逆转录病毒治疗的HIV-1感染成年人中虚弱的患病率,并分析其相关因素。

方法

对年龄≥30岁且接受抗逆转录病毒治疗至少6个月的HIV感染者进行了一项横断面研究。主要评估采用弗里德虚弱表型评分,将受试者分为非虚弱、虚弱前期或虚弱。对与虚弱相关的因素进行了特征描述,并进行了多因素逻辑回归分析。

结果

共招募了164名受试者;男性受试者118名(72%),中位年龄为40.5岁,CD4最低点中位数为53个细胞/μl。90名(54.9%)受试者被确定为虚弱,其中84名(51.2%)被确定为虚弱前期,6名(3.7%)为虚弱,主要的虚弱表型是握力减弱。多变量模型显示,抑郁是与虚弱前期和虚弱显著相关的唯一因素(OR 2.14;95%CI 1.04-4.43,p=0.036)。

结论

在接受抗逆转录病毒治疗的HIV感染患者中,虚弱很常见,抑郁是一个独立的预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef39/7061977/eb29cd208b34/CHIVR-17-204_F1.jpg

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