Inflammation Strikes Again: Frailty and HIV
Purpose of Review
As a consequence of antiretroviral therapy, the proportion of older HIV-infected adults is increasing, with a concomitant shift in burden of illness to age-related syndromes and disease. Frailty is an age-related syndrome of increased vulnerability to stress, predictive of major adverse clinical outcomes among HIV-infected and uninfected persons alike. Understanding frailty pathogenesis is critical to developing interventions to improve health outcomes in HIV. Here, we review the current evidence for the relationship between inflammation and frailty in HIV, and the potential for novel, inflammation-targeted interventions.
Dysregulated inflammation has been consistently associated with frailty in elderly HIV-uninfected persons. Dysregulated inflammation is also central to HIV pathophysiology and several recent studies have demonstrated the important association of inflammation with frailty in HIV. Some evidence suggests that anti-inflammatory therapies may be effective in ameliorating the adverse impact of frailty among aging HIV-infected adults, though further investigation is necessary.
Inflammation has been implicated in frailty in HIV infection, and improved understanding of the role that inflammation plays in frailty pathogenesis is key to the development of effective therapies to slow or prevent frailty in the vulnerable HIV-infected population.
KeywordsAntiretroviral therapy Dysregulated inflammation HIV infection Inflammation Frailty pathogenesis
Preparation of this work was supported, in part, by the National Institute of Aging and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (K23AG050260; R01AG054366 to KME; K23AI108357 to DAP) and the Robert Wood Johnson Foundation Harold Amos Award (to DAP). Contents are the authors’ sole responsibility and do not necessarily represent the official views of the National Institutes of Health or the Robert Wood Johnson Foundation.
Compliance with Ethical Standards
Conflict of Interest
Stephanie M. Fukui declares no competing interests. Damani A. Piggott has received grants from the National Institute of Aging and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (K23AI108357) and the Robert Wood Johnson Foundation Harold Amos Award (to DAP). Kristine M. Erlandson has received grants from National Institute of Aging of the National Institutes of Health (K23AG050260; R01AG054366), Gilead Sciences, and Merck; research funding from Gilead Sciences; and has served as a consultant to Gilead Sciences, Serono, and Theratechnologies.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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