Department of HIV Medicine, Royal Free London NHS Foundation Trust, London, UK.
Institute for Global Health, University College London, London, UK.
Br J Hosp Med (Lond). 2022 Jun 2;83(6):1-7. doi: 10.12968/hmed.2021.0474. Epub 2022 Jun 20.
The population of people living with human immunodeficiency virus (HIV) is ageing and has an increasing burden of non-acquired immune deficiency syndrome (AIDS)-related morbidity and mortality, including frailty. Frailty is prevalent at a younger age in this population and is associated with multimorbidity, disability and death. This article examines the key interventions to ameliorate the advancement of frailty in people living with HIV. It explores methods of successfully delivering a multidisciplinary holistic approach to this complex patient group, using three case studies. The most effective frailty intervention is exercise. Group-based physiotherapy classes protect against functional decline and frailty symptomatology. Optimisation of medical and psychiatric comorbidities, including deprescribing when appropriate, is also essential. Addressing the social determinants of frailty, such as social isolation and loneliness, are beneficial, but are dependent on local charities and resources. More research is required to assess pharmacological and nutritional interventions in frailty. This requires a greater understanding of the exact pathophysiology of frailty, which remains poorly understood.
随着感染人类免疫缺陷病毒 (HIV) 的人群老龄化，与非获得性免疫缺陷综合征 (AIDS) 相关的发病率和死亡率不断增加，包括虚弱。在这一人群中，虚弱更为普遍，且与多种疾病、残疾和死亡相关。本文探讨了改善 HIV 感染者虚弱状况的关键干预措施。通过三个案例研究，探讨了成功为这一复杂患者群体提供多学科整体方法的方法。最有效的虚弱干预措施是锻炼。小组基础物理疗法课程可预防功能下降和虚弱症状。优化医疗和精神共病，包括在适当情况下的减药，也是必不可少的。解决脆弱的社会决定因素，如社会隔离和孤独，是有益的，但取决于当地的慈善机构和资源。需要更多的研究来评估脆弱方面的药物和营养干预，这需要更深入地了解脆弱的确切病理生理学，而这一点仍了解不足。
