Hıv ile Enfekte 40 Yaş Üstü Bireylerde Kırılganlığın Tanımlanması Ve İlişkili Risk Faktörlerinin Belirlenmesi

Abstract

The epidemic caused by the human immunodeficiency virus (HIV) was first recognized in the USA in the early 1980s and shortly afterwards throughout the world. It affected younger populations with devastating effects. Before effective combination antiretroviral therapy (cART) became available in the 1990s, most patients with HIV infection had an inexorable down-hill course dominated by infections, tumors, wasting, and death. Now, in most instances, patients with HIV treated with cART live with their disease successfully. However as people living with HIV age, they face a variety of new challenges including possible accelerated aging and higher rates of co-morbidities such as cardiovascular disease. They also develop geriatric syndromes and frailty earlier than uninfected people. Thus patients with HIV on cART have far less life-threatening acute illnesses, but must confront issues related to the aging process and ‘inflammaging’. An estimated 3.6 million of the 35.6 million people (%10) worldwide living with HIV are over the age of 50 years, in the USA, 50% of 1.3 million HIV-positive patients are over 50 years old and it is estimated that this ratio will increase to 70% in 2030. The relationship between accelerated aging and HIV is still controversial, but datas have shown that the inflammatory process is continuing even in HIV-positive patients who have a negative viral load and high level of CD4 levels. As a result, the risk of cardiovascular, renal, oncologic, and osteoporotic diseases is increasing among these patients, especially over the age of 40. Therefore, there is a significant threat to the aging HIV population; for example frailty 'occurs at earlier age in HIV-positive individuals. Frailty is a geriatric syndrome characterized by diminished physical activity, decreased walking speed, weight loss, muscle loss and exhaution, all of which develop as a result of cumulative decline in many physiological systems throughout life. The aim of this study is to identify the prevalence of frailty in HIV infected Turkish patients and associated risk factors.