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Low levels of frailty in HIV-positive older adults on antiretroviral therapy in northern Tanzania

Lookup NU author(s): Grace George, Professor Richard Walker, Dr Catherine DotchinORCiD, Dr Elizabeta Mukaetova-Ladinska, Dr Stella Paddick



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s).There are over 3 million people in sub-Saharan Africa (SSA) aged 50 and over living with HIV. HIV and combined antiretroviral therapy (cART) exposure may accelerate the ageing in this population, and thus increase the prevalence of premature frailty. There is a paucity of data on the prevalence of frailty in an older HIV + population in SSA and screening and diagnostic tools to identify frailty in SSA. Patients aged ≥ 50 were recruited from a free Government HIV clinic in Tanzania. Frailty assessments were completed, using 3 diagnostic and screening tools: the Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and Brief Frailty Instrument for Tanzania (B-FIT 2). The 145 patients recruited had a mean CD4 + of 494.84 cells/µL, 99.3% were receiving cART and 72.6% were virally suppressed. The prevalence of frailty by FFP was 2.758%. FFP frailty was significantly associated with female gender (p = 0.006), marital status (p = 0.007) and age (p = 0.038). Weight loss was the most common FFP domain failure. The prevalence of frailty using the B-FIT 2 and the CFS was 0.68%. The B-FIT 2 correlated with BMI (r = − 0.467, p = 0.0001) and CD4 count in females (r = − 0.244, p = 0.02). There is an absence of frailty in this population, as compared to other clinical studies. This may be due to the high standard of HIV care at this Government clinic. Undernutrition may be an important contributor to frailty. It is unclear which tool is most accurate for detecting the prevalence of frailty in this setting as levels of correlation are low.

Publication metadata

Author(s): Bristow C, George G, Hillsmith G, Rainey E, Urasa S, Koipapi S, Kisoli A, Boni J, Saria GA, Ranasinghe S, Joseph M, Gray WK, Dekker M, Walker RW, Dotchin CL, Mukaetova-Ladinska E, Howlett W, Makupa P, Paddick S-M

Publication type: Article

Publication status: Published

Journal: Journal of NeuroVirology

Year: 2021

Volume: 27

Issue: 1

Pages: 58-69

Print publication date: 01/02/2021

Online publication date: 11/01/2021

Acceptance date: 28/09/2020

Date deposited: 24/03/2021

ISSN (print): 1355-0284

ISSN (electronic): 1538-2443

Publisher: Springer Science and Business Media Deutschland GmbH


DOI: 10.1007/s13365-020-00915-3


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Funder referenceFunder name
Academy of Medical Sciences (REF:SGL020\1006)
Newcastle University Masters in Research programme.