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Comparative Study
. 2009 Dec;18(12):1965-74.
doi: 10.1089/jwh.2008.1090.

Factors associated with preclinical disability and frailty among HIV-infected and HIV-uninfected women in the era of cART

Arpi S Terzian  1 , Susan Holman, Niyati Nathwani, Esther Robison, Kathleen Weber, Mary Young, Ruth M Greenblatt, Stephen J Gange; Women's Interagency HIV Study
Collaborators, Affiliations
Comparative Study

Factors associated with preclinical disability and frailty among HIV-infected and HIV-uninfected women in the era of cART

Arpi S Terzian et al. J Womens Health (Larchmt). 2009 Dec.

Abstract

Background: HIV-associated immune injury is hypothesized to increase the risk of preclinical disability and frailty via inflammatory pathways. We investigated the role of CD4+ T cell depletion and clinical AIDS on preclinical disability and frailty in HIV-positive women with a history of combination antiretroviral therapy (cART) and HIV-negative women.

Methods: This was a cross-sectional study nested within the Women's Interagency HIV Study (WIHS), a prospective cohort study initiated in 1994 across five U.S. cities. Questionnaires and tests were performed by 573 HIV-negative and 1206 HIV-positive women. Prevalence ratios were computed using regression models.

Results: Severe CD4+ cell depletion was an independent predictor of slowness, weakness, and frailty in HIV-positive women compared with HIV-negative women. Women with CD4+ counts<100 cells/mm3 were 0.13 seconds slower to complete 4 meters (95% CI 0.06-0.21), 1.25 kg weaker (95% CI -2.31--0.19), and had 2.7 times higher prevalence of frailty (95% CI 1.46-5.01).

Conclusions: This study is one of the largest studies to administer performance-based tests to investigate disability and frailty in HIV-positive women. HIV-positive women with intact immune systems and without a history of clinical AIDS were no different from HIV-negative women on tests of slowness, weakness, and frailty phenotype.

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