Frailty predicts Health Related Quality of Life in HIV infected patients

Ana Rita Silva

HRQoL is a relevant feature in people living with HIV (PLWH)1. Frailty is associated to both medical and patient related outcomes2. We explore the association between Frailty and HRQoL in PLWH.

Consecutive patients at the MHMC in 2015 with effective antiretroviral therapy (ART).
Medical health outcomes:
– Non-infectious comorbidities (NICM) and Multimorbidity (MM) defined as >2 NICM.
– HIV related variables including ART duration, current and nadir CD4
Patients health outcomes: Depression (CES-D scale); HRQoL (EuroQoL questionnaire)
– Frailty Phenotype (FP) according to Fried criteria3
– Frailty Index (FI) using a validated algorithm4
Descriptive analysis using EQ-5D-5L tertiles. Logistic regression models were created using the 1st tertile (-1 to 0,871) as reference.

252 patients, 76 (30%) in the 1st tertile of HRQoL.
Median values for FP and FI were 1 (IQR: 0-1, 3rd level in 13 (5%) patients) and 0.2 (IQR: 0.22-0.35, 3rd level in 15 (6%) patients), respectively.
At multivariable logistic regression, both continuum and categorical FI and FP were associated with worse HRQoL (OR=1.73 p=0.01 and OR=41 p<0.01 respectively).
Depression was also associated with lower HRQoL (FI: OR=2.32 and FP: OR=9.84, all p<0.01).

FI and FP are simple clinical tools correlated with HRQoL in any age group, suitable for medical visit. Intervention targeting frailty and depression may improve HRQoL in PLWH.

Anna Scotti
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