Relationship between a frailty-related phenotype and progressive deterioration of the immune system in HIV-infected men

Loic Desquilbet*, Joseph B. Margolick, Linda P. Fried, John P. Phair, Beth D. Jamieson, Marcy Holloway, Lisa P. Jacobson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

117 Scopus citations

Abstract

CONTEXT: Immunological similarities have been noted between HIV-infected individuals and older HIV-negative adults. Immunologic alterations with aging have been noted in frailty in older adults, a clinical syndrome of high risk for mortality and other adverse outcomes. Using a frailty-related phenotype (FRP), we investigated in the Multicenter AIDS Cohort Study whether progressive deterioration of the immune system among HIV-positive individuals independently predicts onset of FRP. METHODS: FRP was evaluated semiannually in 1046 HIV-infected men from 1994 to 2005. CD4 T-cell count and plasma viral load were evaluated as predictors of FRP by logistic regression (generalized estimating equations), adjusting for age, ethnicity, educational level, AIDS status, and treatment era [pre-highly active antiretroviral therapy (HAART) (1994-1995) and HAART (1996-1999 and 2000-2005)]. RESULTS: Adjusted prevalences of FRP remained low for CD4 T-cell counts >400 cells per cubic millimeter and increased exponentially and significantly for lower counts. Results were unaffected by treatment era. After 1996, CD4 T-cell count, but not plasma viral load, was independently associated with FRP. CONCLUSIONS: CD4 T-cell count predicted the development of a FRP among HIV-infected men, independent of HAART use. This suggests that compromise of the immune system in HIV-infected individuals contributes to the systemic physiologic dysfunction of frailty.

Original languageEnglish (US)
Pages (from-to)299-306
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume50
Issue number3
DOIs
StatePublished - Mar 2009

Keywords

  • Aging
  • CD4 T-cell count
  • Frailty
  • HIV
  • Highly active antiretroviral therapy
  • Prospective population-based cohort

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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