University Health Network, University of Toronto, Toronto, Ontario, Canada.
McGill University Health Centre, McGill University, Montréal, Québec, Canada.
J Acquir Immune Defic Syndr. 2024 Nov 1;97(3):226-231. doi: 10.1097/QAI.0000000000003485. Epub 2024 Oct 7.
BACKGROUND: Advancements in treatment have resulted in improved survival among people living with HIV. However, additional years of life are not necessarily spent in good health, as frailty tends to develop at a younger age among people living with HIV. We set out to examine the prevalence of frailty and its correlates among older adults living with HIV in Canada, with a primary interest in nadir CD4 count. METHODS: We performed a cross-sectional analysis of the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study, a Canadian cohort of people living with HIV aged 65 years or older. Participants were assessed using the Fried Frailty Phenotype at cohort entry, and those meeting ≥3 criteria were characterized as frail. We used Poisson regression with robust standard errors to estimate the association between nadir CD4 count and frailty, as well as age, gender, time since HIV diagnosis, comorbidities, marital status, and loneliness. RESULTS: Among 439 participants included in this analysis (median age 69 years, interquartile ranges 67-73), prevalence of frailty was 16.6%. Frailty was not associated with nadir CD4 count. Not being in a relationship (aRR 2.09, 95% CI 1.01 to 4.30) and greater degree of loneliness (aRR 1.25 per 10 point increase on UCLA loneliness scale, 95% CI 1.09 to 1.44) were associated with frailty. CONCLUSIONS: Frailty occurred in 16.6% of older adults living with HIV in this cohort. While nadir CD4 count did not correlate with frailty, being single and lonely did, highlighting the importance of recognizing and addressing these social vulnerabilities among people aging with HIV.
背景:随着治疗方法的进步,HIV 感染者的生存时间得到了延长。然而,并非所有的延长生命都能保持良好的健康状况,因为 HIV 感染者的虚弱状态往往会在更年轻时出现。我们着手研究加拿大老年 HIV 感染者中虚弱的流行情况及其相关因素,主要关注 CD4 计数的最低点。
方法:我们对加拿大老年 HIV 感染者健康老龄化的相关因素(CHANGE HIV)研究进行了横断面分析,该研究是一个由年龄在 65 岁及以上的 HIV 感染者组成的队列。参与者在队列入组时接受了 Fried 虚弱表型评估,符合≥3 项标准的人被定义为虚弱。我们使用泊松回归和稳健标准差来估计 CD4 计数最低点与虚弱之间的关联,以及年龄、性别、HIV 诊断后时间、合并症、婚姻状况和孤独感。
结果:在这项分析中,纳入了 439 名参与者(中位数年龄 69 岁,四分位间距 67-73 岁),虚弱的患病率为 16.6%。虚弱与 CD4 计数最低点无关。没有伴侣(调整后的 RR 2.09,95%CI 1.01 至 4.30)和更高程度的孤独感(UCLA 孤独量表每增加 10 分,调整后的 RR 1.25,95%CI 1.09 至 1.44)与虚弱有关。
结论:在这个队列中,16.6%的老年 HIV 感染者出现了虚弱。虽然 CD4 计数最低点与虚弱无关,但单身和孤独感与虚弱有关,这强调了在 HIV 感染者老龄化过程中识别和解决这些社会脆弱性的重要性。
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