Addressing Frailty in People Over 60 Living With HIV: Insights From the 'MasdeSesenta' Project. Preliminary results.

Background: People living with HIV (PLWH) experience an accelerated aging due to different mechanisms (immune activation and chronic inflammation, greater loss of muscle mass due to both the disease itself and antiretroviral therapy, among other factors). This accelerated aging is characterized by an increased risk of developing frailty, leading to a higher likelihood of adverse events and worse quality of life.

Objective: The main goal of this pilot study is to evaluate the effect of a 6-month multidomain intervention on changes on functional performance over an one-year follow-up of pre-frail and frail PLWH aged 60 and above (OPLWH).

Materials and methods: OPLWH followed at the Infectious Disease Unit of Hospital Universitario Clínico San Carlos with ≥1 Fried criteria were included in this quasi-experimental study. Functional, physical performance (Short Physical Performance Battery-SPPB-, walking speed-WS), sarcopenia parameters (hand-grip-HG, dynamic muscle strength-DMS) and sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, nutritional (adherence to Mediterranean diet) and body composition variables (rectus femoris ultrasound), as well as quality of life were assessed at baseline and at 3 months. A multicomponent intervention, which included physical exercise, nutritional intervention, and pharmacological optimization, was conducted. Differences between pre- and post-intervention moments were examined using the independent t-test.

Results: Seven prefrail OPLWH (72.1±1.8yo) were included. At follow-up, 3 of them improved to a robust status and 4 remained prefrail. The multidomain intervention significantly increased DMS [16.33kg (95%CI 4.45-28-22; p=0.02)] and muscle thickness [1.77mm (95%CI 0.11-3.44; p=0.04)]. A clinically, although no statistically, significant difference was observed in SPPB [1 (95%CI 0.31-2.31; p=0.11)]. Nevertheless, significant improvements were detected when a sensitivity analysis was conducted examined only those with worse SPPB scores (<10) at baseline.

Conclusions: A multidomain intervention in prefrail OPLWH improves sarcopenia parameters (strength muscle and muscle mass) and physical performance.