SidaSubSaharaV1, Pmc, Corpus, bibRecord, 001910

Frailty in HIV-infected adults in South Africa

Identifieur interne : 001910 ( Pmc/Corpus ); précédent : 001909; suivant : 001911

Frailty in HIV-infected adults in South Africa

Auteurs : Sophia Pathai ; Clare Gilbert ; Helen A. Weiss ; Colin Cook ; Robin Wood ; Linda-Gail Bekker ; Stephen D. Lawn

Source :

Journal of acquired immune deficiency syndromes (1999) [ 1525-4135 ] ; 2013.

RBID : PMC:3772340

Abstract

Objectives

Some evidence suggests that HIV infection is associated with premature frailty -a syndrome typically viewed as being related to ageing. We determined the prevalence and predictors of frailty in a population of HIV-infected individuals in South Africa.

Design

Case-control study of 504 adults over the age of 30 years, composed of 248 HIV-infected adults and 256 age- and gender- frequency-matched HIV-seronegative individuals.

Methods

Frailty was defined by standardized assessment comprised of ≥3 of: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Independent predictors of frailty were evaluated using multivariable logistic regression.

Results

The mean ages of the HIV-infected and HIV-seronegative groups were 41.1±7.9 years and 42.6±9.6 years respectively. Of the HIV-infected adults, 87.1% were receiving antiretroviral treatment (ART) (median duration, 58 months), their median CD4 count was 468 cells/μL (IQR:325-607 cells/μL) and 84.3% had undetectable plasma viral load. HIV-infected adults were more likely to be frail than HIV-seronegative individuals (19.4% vs.13.3%;p=0.07), and this association persisted after adjustment for confounding variables (adjusted odds ratio [OR] 2.14; 95% confidence interval [95%CI]: 1.16-3.92, p=0.01). Among HIV-infected individuals, older age was a strong predictor of frailty, especially among women (women: OR=2.55 per 10-year age increase; men: OR=1.29 per 10 year age increase, p-interaction=0.01). Lower current CD4 count (<500 cells/μL) was also independently associated with frailty (OR=2.84;95%CI:1.02-7.92, p=0.04).

Conclusion

HIV infection is associated with premature development of frailty, especially in women. Since higher CD4 counts were associated with lower risk of frailty, earlier initiation of ART may be protective.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772340

DOI: 10.1097/QAI.0b013e318273b631
PubMed: 23018372
PubMed Central: 3772340

Links to Exploration step

PMC:3772340

Le document en format XML

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<author><name sortKey="Pathai, Sophia" sort="Pathai, Sophia" uniqKey="Pathai S" first="Sophia" last="Pathai">Sophia Pathai</name>
<affiliation><nlm:aff id="A1">International Centre for Eye Health, Dept of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A4">Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gilbert, Clare" sort="Gilbert, Clare" uniqKey="Gilbert C" first="Clare" last="Gilbert">Clare Gilbert</name>
<affiliation><nlm:aff id="A1">International Centre for Eye Health, Dept of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.</nlm:aff>
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<author><name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A." last="Weiss">Helen A. Weiss</name>
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<author><name sortKey="Cook, Colin" sort="Cook, Colin" uniqKey="Cook C" first="Colin" last="Cook">Colin Cook</name>
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<author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name>
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<affiliation><nlm:aff id="A4">Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.</nlm:aff>
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<author><name sortKey="Gilbert, Clare" sort="Gilbert, Clare" uniqKey="Gilbert C" first="Clare" last="Gilbert">Clare Gilbert</name>
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</affiliation>
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<author><name sortKey="Weiss, Helen A" sort="Weiss, Helen A" uniqKey="Weiss H" first="Helen A." last="Weiss">Helen A. Weiss</name>
<affiliation><nlm:aff id="A2">MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK</nlm:aff>
</affiliation>
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<author><name sortKey="Cook, Colin" sort="Cook, Colin" uniqKey="Cook C" first="Colin" last="Cook">Colin Cook</name>
<affiliation><nlm:aff id="A3">Dept. of Ophthalmology, Faculty of Health Sciences, University of Cape Town, H53 Old Main Building, Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Wood, Robin" sort="Wood, Robin" uniqKey="Wood R" first="Robin" last="Wood">Robin Wood</name>
<affiliation><nlm:aff id="A4">Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Bekker, Linda Gail" sort="Bekker, Linda Gail" uniqKey="Bekker L" first="Linda-Gail" last="Bekker">Linda-Gail Bekker</name>
<affiliation><nlm:aff id="A4">Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.</nlm:aff>
</affiliation>
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<author><name sortKey="Lawn, Stephen D" sort="Lawn, Stephen D" uniqKey="Lawn S" first="Stephen D." last="Lawn">Stephen D. Lawn</name>
<affiliation><nlm:aff id="A4">Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A5">Dept. of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.</nlm:aff>
</affiliation>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title>
<p id="P1">Some evidence suggests that HIV infection is associated with premature frailty -a syndrome typically viewed as being related to ageing. We determined the prevalence and predictors of frailty in a population of HIV-infected individuals in South Africa.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Case-control study of 504 adults over the age of 30 years, composed of 248 HIV-infected adults and 256 age- and gender- frequency-matched HIV-seronegative individuals.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Frailty was defined by standardized assessment comprised of ≥3 of: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Independent predictors of frailty were evaluated using multivariable logistic regression.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">The mean ages of the HIV-infected and HIV-seronegative groups were 41.1±7.9 years and 42.6±9.6 years respectively. Of the HIV-infected adults, 87.1% were receiving antiretroviral treatment (ART) (median duration, 58 months), their median CD4 count was 468 cells/μL (IQR:325-607 cells/μL) and 84.3% had undetectable plasma viral load. HIV-infected adults were more likely to be frail than HIV-seronegative individuals (19.4% vs.13.3%;p=0.07), and this association persisted after adjustment for confounding variables (adjusted odds ratio [OR] 2.14; 95% confidence interval [95%CI]: 1.16-3.92, p=0.01). Among HIV-infected individuals, older age was a strong predictor of frailty, especially among women (women: OR=2.55 per 10-year age increase; men: OR=1.29 per 10 year age increase, p-interaction=0.01). Lower current CD4 count (<500 cells/μL) was also independently associated with frailty (OR=2.84;95%CI:1.02-7.92, p=0.04).</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">HIV infection is associated with premature development of frailty, especially in women. Since higher CD4 counts were associated with lower risk of frailty, earlier initiation of ART may be protective.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id>
<journal-id journal-id-type="pubmed-jr-id">21821</journal-id>
<journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id>
<journal-title-group><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title>
</journal-title-group>
<issn pub-type="ppub">1525-4135</issn>
<issn pub-type="epub">1944-7884</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23018372</article-id>
<article-id pub-id-type="pmc">3772340</article-id>
<article-id pub-id-type="doi">10.1097/QAI.0b013e318273b631</article-id>
<article-id pub-id-type="manuscript">EMS54346</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Frailty in HIV-infected adults in South Africa</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Pathai</surname>
<given-names>Sophia</given-names>
</name>
<degrees>MSc MRCOphth</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gilbert</surname>
<given-names>Clare</given-names>
</name>
<degrees>FRCOphth MSc MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Weiss</surname>
<given-names>Helen A.</given-names>
</name>
<degrees>DPhil</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cook</surname>
<given-names>Colin</given-names>
</name>
<degrees>FCOphth (SA)</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wood</surname>
<given-names>Robin</given-names>
</name>
<degrees>MMed FCP</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bekker</surname>
<given-names>Linda-Gail</given-names>
</name>
<degrees>FCP, PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lawn</surname>
<given-names>Stephen D.</given-names>
</name>
<degrees>FRCP MD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
International Centre for Eye Health, Dept of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.</aff>
<aff id="A2"><label>2</label>
MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK</aff>
<aff id="A3"><label>3</label>
Dept. of Ophthalmology, Faculty of Health Sciences, University of Cape Town, H53 Old Main Building, Groote Schuur Hospital, Observatory 7925, Cape Town, South Africa.</aff>
<aff id="A4"><label>4</label>
Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, Cape Town, South Africa.</aff>
<aff id="A5"><label>5</label>
Dept. of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.</aff>
<author-notes><corresp id="CR1">Correspondence to: Sophia Pathai: <email>sophia.pathai@lshtm.ac.uk</email>
 Tel: +44 20 7958 8343 Fax: +44 20 7958 8325</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>20</day>
<month>8</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><day>1</day>
<month>1</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>13</day>
<month>9</month>
<year>2013</year>
</pub-date>
<volume>62</volume>
<issue>1</issue>
<fpage>43</fpage>
<lpage>51</lpage>
<abstract><sec id="S1"><title>Objectives</title>
<p id="P1">Some evidence suggests that HIV infection is associated with premature frailty -a syndrome typically viewed as being related to ageing. We determined the prevalence and predictors of frailty in a population of HIV-infected individuals in South Africa.</p>
</sec>
<sec id="S2"><title>Design</title>
<p id="P2">Case-control study of 504 adults over the age of 30 years, composed of 248 HIV-infected adults and 256 age- and gender- frequency-matched HIV-seronegative individuals.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Frailty was defined by standardized assessment comprised of ≥3 of: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Independent predictors of frailty were evaluated using multivariable logistic regression.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">The mean ages of the HIV-infected and HIV-seronegative groups were 41.1±7.9 years and 42.6±9.6 years respectively. Of the HIV-infected adults, 87.1% were receiving antiretroviral treatment (ART) (median duration, 58 months), their median CD4 count was 468 cells/μL (IQR:325-607 cells/μL) and 84.3% had undetectable plasma viral load. HIV-infected adults were more likely to be frail than HIV-seronegative individuals (19.4% vs.13.3%;p=0.07), and this association persisted after adjustment for confounding variables (adjusted odds ratio [OR] 2.14; 95% confidence interval [95%CI]: 1.16-3.92, p=0.01). Among HIV-infected individuals, older age was a strong predictor of frailty, especially among women (women: OR=2.55 per 10-year age increase; men: OR=1.29 per 10 year age increase, p-interaction=0.01). Lower current CD4 count (<500 cells/μL) was also independently associated with frailty (OR=2.84;95%CI:1.02-7.92, p=0.04).</p>
</sec>
<sec id="S5"><title>Conclusion</title>
<p id="P5">HIV infection is associated with premature development of frailty, especially in women. Since higher CD4 counts were associated with lower risk of frailty, earlier initiation of ART may be protective.</p>
</sec>
</abstract>
<kwd-group><kwd>HIV</kwd>
<kwd>AIDS</kwd>
<kwd>frailty</kwd>
<kwd>premature ageing</kwd>
<kwd>South Africa</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United Kingdom">Wellcome Trust : </funding-source>
<award-id>088590 || WT</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>

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Frailty in HIV-infected adults in South Africa

Frailty in HIV-infected adults in South Africa

Source :

Abstract

Links to Exploration step

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