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Antivir Ther. 2018;23(2):117-127. doi: 10.3851/IMP3185.

Frailty in men living with HIV: a cross-sectional comparison of three frailty instruments.

Yeoh HL1,2,3, Cheng A1,2,4, Palmer C1,2,3, Crowe SM1,2,3, Hoy JF1,2.

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Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia.
Department of Infectious Diseases, Monash University, Melbourne, Australia.
Burnet Institute, Melbourne, Australia.
Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.



Potent antiretroviral treatment has resulted in near normal life expectancy for people living with HIV. Consequently, there is an increased focus on comorbidities, frailty and quality of life.


We assessed and compared the prevalence of frailty, associated factors and relationship with quality of life in older Australian men living with HIV in a cross-sectional study using three frailty measurements. The Frailty Phenotype, Frailty Index and Edmonton Frail Scale were applied to 93 HIV-infected men aged over 50 years, on antiretroviral therapy. Multivariable ordinal logistic regression was used to analyse the associations of frailty with covariates and quality of life.


The prevalence of frailty was 10.8% (n=10) using the Frailty Phenotype; 22.6% (n=21) using the Frailty Index and 15.1% (n=14) using the Edmonton Frail Scale. Frailty Phenotype-defined pre-frailty/frailty was associated with pre-1996 ART initiation (OR, 3.56; CI, 1.23, 10.36; P=0.020) and depression (OR, 3.74; CI, 1.24, 11.27; P=0.019). Osteoporosis, serious non-AIDS events and AIDS were associated with Frailty Index-defined frailty (OR, 4.84, CI, 1.27, 18.43, P=0.021; OR, 4.27, CI, 1.25, 14.58, P=0.020; OR, 4.62, CI, 1.30, 16.45, P=0.018, respectively) and Edmonton Frail Scale-defined frailty (OR, 7.51; CI, 1.55, 36.42; P=0.012; OR, 7.71; CI, 1.62, 36.75; P=0.010; OR, 8.53; CI, 1.70, 42.73; P=0.009, respectively), independent of age and current CD4+ T-cell count. Frailty, defined by any of the instruments, was significantly associated with poorer quality of life (P<0.001).


Identifying frailty is an increasingly important contemporary consideration of HIV care related to ageing and quality of life.


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