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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Frailty in HIV-infected adults in South Africa</title><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></affiliation></author><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></author><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></author><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></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23018372</idno><idno type="pmc">3772340</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3772340</idno><idno type="RBID">PMC:3772340</idno><idno type="doi">10.1097/QAI.0b013e318273b631</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001910</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001910</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Frailty in HIV-infected adults in South Africa</title><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></affiliation></author><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></author><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></author><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></author></analytic><series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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>Pour manipuler ce document sous Unix (Dilib)
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