TITLE:
Frailty in People Living with Human Immunodeficiency Virus Aged 50 Years and Older: Prevalence and Predictors
AUTHORS:
Alassane Ndiaye, Ndèye Fatou Ngom, Kiné Ndiaye, Assiétou Gaye, Elhadji Bara Diop, Ahmadou Mboup, Houlèye Saou, Bessoume Sy, Ababacar Niang, Betty Fall, Mame Awa Faye
KEYWORDS:
Frailty, HIV, Senior, Dakar
JOURNAL NAME:
World Journal of AIDS,
Vol.14 No.1,
March
11,
2024
ABSTRACT: Introduction: Life expectancy improvement for people living with Human Immunodeficiency Virus (HIV) is coming up against the problems associated with aging and chronic diseases. Frailty is a concern affecting a growing number of patients, particularly the elderly in this population. Our study aimed to determine the prevalence of frailty and its predictors on people living with HIV aged 50 years and older followed at the Outpatient Treatment Clinic (CTA) in Dakar. Methodology: We conducted a cross-sectional study of descriptive and analytic purposes ranging from November 2022 to August 2023, in CTA, Dakar (Senegal). We included people living with HIV aged 50 years and older under antiretroviral therapy for at least 6 months (≥6 months). Frailty was considered according to Fried criteria with a score ≥3. To identify the predictors of frailty, we performed a multivariate logistic regression analysis using STATA software version 18. Results: We included 199 patients. The median age at the moment of the study was 58 years old [50 - 91] with a sex ratio (M/F) of 0.58. The most representative age group was that of [50 - 59] years (59.3%). HIV-1 profile was most common in 89.45%. The median duration under antiretroviral therapy was 180 months [6 - 284] and 94% of patients received a Tenofovir Disoproxil Fumarate (TDF)-containing regimen with 43% of them for at least 10 years. Viral load was undetectable (≤40 copies/ml) in 98% of cases. WHO Stage III was more common at inclusion and 55.78% had nadir TCD4+ Lymphocyte counts < 200 elements/mm3. In our study, 80% of patients underwent at least one comorbidity (≥1) and 31% of patients had polymedication (≥5). Nutritional disorder was found in 65 patients. Frailty and prefrailty appeared in 28% and 36% of cases respectively. In multivariate analysis, nutritional disorder [aOR = 3.8 (2.3 - 6.4)], length of TDF-containing regimen exposure ≥10 years [aOR = 29.03 (9.5 - 89.7)], and polypharmacy [aOR = 1.53 (1.1 - 2.12)] were associated with frailty. Conclusion: Our study confirms the high prevalence of frailty among older people living with HIV. Its prevention should consider the management of comorbidities and the implementation of non-pharmacological interventions such as nutrition.