Prevalence, clinical and immunological predictors of frailty among older adults with HIV in Kampala

Award amount: 30,000.00

Phoebe Mbabazi, MD, Recipient
Peter Hunt, MD, Mentor

People with HIV (PWH) in sub- Saharan Africa are living longer due to increased access to anti-retroviral therapy (ART). Nevertheless, there are high rates of age-related complications in adults with HIV partly due to persistent low-grade chronic inflammation. HIV is associated with premature onset of frailty, which occurs earlier and more frequently than in people without HIV. There is a paucity of published data on frailty in sub-Saharan Africa among persons with HIV, with studies reporting a wide range of prevalence estimates and few have focused on older adults. The factors driving frailty among older adults with HIV in sub- Saharan Africa need to be better understood. In this study, we will 1) determine the prevalence and factors associated with frailty among older adults with HIV enrolled in the geriatric cohort at the infectious diseases institute (IDI) in Kampala, and 2) study the association of immune activation, immune senescence and frailty among older adults with HIV enrolled in the geriatric cohort at IDI. This study will be carried out as a sub-study in a European and Developing Countries Clinical Trials Partnership (EDTCP) funded geriatric cohort at IDI over a six- month period. In the first aim, we will assess the prevalence and clinical predictors of frailty among 288 participants aged 60 years and above with HIV receiving anti-retroviral therapy (ART). In the second aim, we will perform a case-control analysis among those with (n=30) and without (n=30) frailty to determine the associations between markers of immune activation, senescence and frailty. Data obtained will be used to generate hypotheses for further research that is targeted towards prevention and management of frailty among older adults with HIV in order to improve on their quality of life.