Section of Geriatrics, Department of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
AIDS Res Hum Retroviruses. 2022 Jul;38(7):538-543. doi: 10.1089/AID.2021.0214. Epub 2022 Apr 25.
Polypharmacy and frailty are correlated in Persons Living with HIV (PLWH) in the United States, but little is known about their correlation in resource-limited settings. Our cross-section study evaluated the correlation between polypharmacy and frailty among Thai 324 virally suppressed PLWH and 132 uninfected patients aged ≥50 between March 2016 and April 2017. The primary predictor was the number of patient-reported non-antiretroviral therapy (ART) medications. The outcome was having additional domain of the five Fried frailty phenotype domains (0 = normal, 1-2 = prefrail, >3 = frail). Most participants were male (63% PLWH, 67% uninfected) with few comorbidities (1.4 PLWH, 0.9 uninfected) and small median number of non-ART medications (2 PLWH, 1 uninfected). Frailty was uncommon (8.6% PLWH, 3.8% uninfected). Each additional non-ART medication correlated with 6% increased likelihood of having additional frailty domain among PLWH (95% CI: 0.002-0.11, = .04) but not statistically significant among the uninfected. The association between polypharmacy and frailty is more pronounced in Thai PLWH than in participants without HIV. Further study is warranted to confirm this association in other resource-limited settings and explore potential deprescribing practices.
美国的 HIV 感染者（PLWH）中普遍存在药物滥用和衰弱的情况，但在资源有限的环境中，这两者之间的相关性知之甚少。本横断面研究评估了 2016 年 3 月至 2017 年 4 月期间 324 名病毒抑制的泰国 PLWH 和 132 名未感染的年龄≥50 岁的患者中，药物滥用和衰弱之间的相关性。主要预测因素是非抗逆转录病毒治疗（ART）药物的患者报告数量。结果是存在五个弗莱德衰弱表型领域的其他领域（0=正常，1-2=衰弱前期，>3=衰弱）。大多数参与者为男性（PLWH 为 63%，未感染组为 67%），合并症较少（PLWH 为 1.4%，未感染组为 0.9%），非 ART 药物的中位数数量较少（PLWH 为 2，未感染组为 1）。衰弱的情况并不常见（PLWH 为 8.6%，未感染组为 3.8%）。每增加一种非 ART 药物，PLWH 发生额外衰弱领域的可能性就会增加 6%（95%CI：0.002-0.11，=0.04），但在未感染组中没有统计学意义。在泰国的 PLWH 中，药物滥用和衰弱之间的关联比在没有 HIV 的参与者中更为明显。需要进一步的研究来确认这一关联在其他资源有限的环境中的存在，并探讨潜在的药物减量实践。
