Lorenz et al reported predictors for frailty in a person 45 years of age or older with HIV. These can help to identify a patient who may benefit from more aggressive management. The authors are from Dana Farber Cancer Institute, Harvard Medical School, University of Texas Medical Branch at Galveston, University of California San Diego, UCLA and Icahn School of Medicine.
Patient selection: HIV-positive age >= 45 years
Endpoint: frailty in the next 30 months (2.5 years)
Medical comorbidities:
(1) cerebrovascular disease
(2) diabetes
(3) COPD
(4) liver disease
(5) bone disease
(6) hypertension
(7) non-AIDS defining cancer
(8) BMI > 35 kg per square meter (Class 2 or 3 obesity)
(9) renal disease
(10) cardiovascular disease
Predictors of frailty:
(1) medical multimorbidity (2 or 3 medical comorbidities HR 2.2; >= 4 HR 5.5)
(2) cerebrovascular disease (HR 3)
(3) diabetes (HR 2.7)
(4) COPD (HR 2)
(5) bone disease (HR 2.8)
(6) liver disease (HR 2; p value 0.0517)
Other factors associated with frailty:
(1) low CD4+ T cell counts or non-suppressed HIV viremia
(2) long-term exposure to some ART drugs
Predictors of decreased or declining grip strength:
(1) cerebrovascular disease
(2) medical multimorbidity
(3) diabetes
(4) COPD
