One-year frailty transitions among persons living with HIV aged 70 years or more on antiretroviral treatment

Abstract Background People living with HIV (PLWH) are aging. Frailty is an age-related condition predictive of hospitalization and mortality. Here, we assessed the frequency and factors associated with frailty transitions at one-year follow-up in elderly PLWH. Method 508 PLWH aged 70 years or older, on antiretroviral treatment, were included in the French multicenter SEPTAVIH study in 2019-2020. Participants were classified as robust, prefrail or frail according to Fried frailty phenotype, at baseline and at one year. Logistic regression models were used to evaluate socioeconomic or medical factors associated with transition between frailty states. Models were adjusted for gender, age at baseline, education, and period of HIV diagnosis (before versus after 1996). Results 17 PLWH died during the one-year follow-up. Of the remaining 491 PLWH, aged 73 years in median, frailty status worsened for 18% of participants and improved for 14% at one year. Advanced age, baseline CD4+ T-cell count below 350 cells/mm3 and type 2 diabetes were associated with transition from prefrailty to frailty: adjusted odds ratio (aOR) 1.10 per a one-year positive difference [95% confidence interval (CI): 1.01; 1.20], 3.05 [1.14; 8.18] and 2.63 [1.05; 6.57], respectively. Being female was associated with more frequent improvement from prefrailty to robustness, aOR 2.50 [1.09; 5.55]. Conclusions Preventing frailty in elderly PLWH is a long-term problem, beginning with the early diagnosis of HIV infection and the management of comorbidities.