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- Title
Frailty, Inflammation, and Mortality Among Persons Aging With HIV Infection and Injection Drug Use.
- Authors
Piggott, Damani A.; Varadhan, Ravi; Mehta, Shruti H.; Brown, Todd T.; Huifen Li; Walston, Jeremy D.; Leng, Sean X.; Kirk, Gregory D.; Li, Huifen
- Abstract
<bold>Background: </bold>Serum markers of inflammation increase with age and have been strongly associated with adverse clinical outcomes among both HIV-infected and uninfected adults. Yet, limited data exist on the predictive and clinical utility of aggregate measures of inflammation. This study sought to evaluate the relationship of a recently validated aggregate inflammatory index with frailty and mortality among aging HIV-infected and uninfected injection drug users.<bold>Methods: </bold>Frailty was assessed among HIV-infected and uninfected participants in the AIDS Linked to the IntraVenous Experience (ALIVE) cohort study using the five Fried phenotypic criteria: weight loss, exhaustion, low physical activity, decreased grip strength, and slow gait. The aggregate inflammatory index was constructed from serum measures of interleukin-6 and soluble tumor necrosis factor-α receptor-1. Multinomial logistic regression was used to assess the relationship of frailty with inflammation. Cox proportional hazards models were used to estimate risk for all-cause mortality.<bold>Results: </bold>Among 1,326 subjects, the median age was 48 years and 29% were HIV-infected. Adjusting for sociodemographics, comorbidity, and HIV status, frailty was significantly associated with each standard deviation increase in log interleukin-6 (odds ratio 1.33; 95% CI, 1.09-1.61), log tumor necrosis factor-α receptor-1 (odds ratio 1.25; 95% CI, 1.04-1.51) and inflammatory index score (odds ratio 1.39; 95% CI, 1.14-1.68). Adjusting for sociodemographics, comorbidity, HIV status, and frailty, the inflammatory index score was independently associated with increased mortality (HR 1.65; 95% CI, 1.44-1.89).<bold>Conclusion: </bold>A recently validated, simple, biologically informed inflammatory index is independently associated with frailty and mortality risk among aging HIV-infected and uninfected injection drug users.
- Subjects
INFLAMMATION; HIV-positive persons; BIOMARKERS; COMORBIDITY; INTRAVENOUS drug abusers; PROPORTIONAL hazards models; INTERLEUKIN-6; ODDS ratio; HIV infection complications; INTRAVENOUS drug abuse; AGING; CELL receptors; FRAIL elderly; HIV infections; INTERLEUKINS; LONGITUDINAL method; RESEARCH funding; BLOOD; DISEASE complications
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2015, Vol 70, Issue 12, p1542
- ISSN
1079-5006
- Publication type
journal article
- DOI
10.1093/gerona/glv107