[Show abstract][Hide abstract] ABSTRACT: 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.
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)].
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.
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.
[Show abstract][Hide abstract] ABSTRACT: Osteoporosis and heart failure are 2 highly prevalent conditions, particularly among the elderly, both of which account for significant morbidity and mortality. In this review, we describe the epidemiology of osteoporosis and osteoporotic-related fractures in persons with heart failure. A review of the current literature regarding shared risk factors for heart failure and osteoporosis is presented, and potential common pathophysiologic mechanisms for these disorders are discussed.
The American Journal of the Medical Sciences 08/2009; 338(1):45-7. DOI:10.1097/MAJ.0b013e3181aaefc1 · 1.39 Impact Factor
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