Montaño-Castellón Iris, Zeballos Diana, Gutiérrez-Peredo Gabriel, Netto Eduardo, Brites Carlos
Post-graduate Program in Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil.
LAPI-Research Laboratory of Infectious Diseases, University Hospital Professor Edgard Santos, School of Medicine, Salvador, Bahia, Brazil.
AIDS Res Hum Retroviruses. 2021 May;37(5):335-342. doi: 10.1089/AID.2020.0113. Epub 2021 Feb 4.
Frailty is associated with an increased probability of serious adverse health outcomes in the geriatric general population. People living with HIV have a higher prevalence of frailty. However, the magnitude of this problem in younger patients in South America is unknown. We aimed to determine the prevalence and factors associated with frailty. This is a cross-sectional study from the Brazilian cohort HIV-AIDS (CoBRA) developed between March and November of 2018, on patients ≥18 years of age. Frailty phenotype was assessed by original Fried criteria. The results were analyzed using descriptive statistics, while identification of factors related to frailty was assessed by using multivariate logistic regression. We enrolled 231 patients; all, but 2 were on antiretroviral therapy (ART). Median age was 45.6 interquartile range (36.7-52.1) years, 136 (58.9%) were male, and 86.7% self-identified as non-white. Mean CD4 count was 660 (±345) cells/mm and 83.5% had undetectable HIV plasma viral load (<50 copies/mL). Prevalence of frailty and prefrailty was 10.4% and 52.4%, respectively. A CD4 count <200 cells/mm, depression, low income, and use of third-line ART were variables significantly associated with a greater risk to present frail or prefrail status. Frailty prevalence increases with age and is an important health problem to health care in HIV aging patients. It requires proper strategies to its early detection, prevention, and management.
衰弱与老年普通人群中严重不良健康结局的概率增加相关。感染艾滋病毒的人群中衰弱的患病率更高。然而，南美洲年轻患者中这一问题的严重程度尚不清楚。我们旨在确定衰弱的患病率及其相关因素。这是一项横断面研究，研究对象为2018年3月至11月期间在巴西艾滋病毒-艾滋病队列研究（CoBRA）中纳入的年龄≥18岁的患者。采用原始的弗里德标准评估衰弱表型。结果采用描述性统计进行分析，而与衰弱相关因素的识别则通过多因素逻辑回归进行评估。我们纳入了231名患者；除2人外，所有人都在接受抗逆转录病毒治疗（ART）。年龄中位数为45.6岁，四分位间距为（36.7 - 52.1）岁，136人（58.9%）为男性，86.7%自我认定为非白人。平均CD4细胞计数为660（±345）个/mm³，83.5%的患者血浆艾滋病毒载量检测不到（<50拷贝/mL）。衰弱和衰弱前期的患病率分别为10.4%和52.4%。CD4细胞计数<200个/mm³、抑郁、低收入以及使用三线抗逆转录病毒治疗是与出现衰弱或衰弱前期状态风险增加显著相关的变量。衰弱患病率随年龄增长而增加，是艾滋病毒感染老年患者医疗保健中的一个重要健康问题。需要采取适当策略对其进行早期检测、预防和管理。
