Frailty in Aging People Living With HIV: a matched controlled Study.

Background We compared the prevalence of frailty among aging People Living with HIV (PLHIV) with people without HIV from the ANS EP58 HAND 55-70 Study. Methods Cross-sectional multicentric study which consecutively included 200 PLHIV and 1000 people without HIV from the French national CONSTANCES cohort, matched on age, sex and education level. PLHIV were aged 55-70 years, with a HIV viral load 200 cells/µl for the last 24 and 12 months respectively. We measured frailty (>2 items) and pre-frailty (one or two items) using a proxy of the 5-item Fried score. Multivariate logistic regression was performed to assess the association between HIV and frailty/pre-frailty, adjusting for demographic, social, behavioural and comorbidity confounders. Results Outcome measures were available for 192 PLHIV and 822 people without HIV. Median age was 62 years, and 84.9% were male. Among PLHIV, the median CD4 cell count was 645.5 cells/µl. Prevalence of frailty/pre-frailty was 5.73%/57.3% in PLHIV vs. 1.73%/52.2% in people without HIV, respectively. HIV was associated with pre-frailty/frailty (OR = 1.89 ; CI95% = 1.37 - 2.61), but after adjusting for social and behavioural factors and comorbidities, HIV was not significantly associated with pre-frailty/frailty (OR = 1.24; 95% CI = 0.84 - 1.81). In PLHIV only, frailty/prefrailty was associated with depressive symptomatology, kidney disease and time since HIV-infection. Conclusions Prevalence of frailty is increased in aging PLHIV with well controlled HIV-disease, but other factors than HIV are predominant, particularly depression and comorbidities.