Frailty and associated clinical factors among Japanese people with HIV: A multicentre cross-sectional study using the...

Frailty is relevant to HIV care across middle and later life, yet Japanese data remain limited. We evaluated frailty, prefrailty and associated factors in Japanese people with HIV using the revised Japanese Cardiovascular Health Study (J-CHS) criteria.

We conducted a multicentre cross-sectional study at eight HIV care centres. Eligible participants were Japanese people with HIV aged ≥40 years on antiretroviral therapy for ≥12 months. Frailty was classified as robust, prefrail or frail. Multivariable logistic regression examined factors associated with frailty-related outcomes; sensitivity analyses excluded sex from the model and restricted analyses to men.

Among 325 participants, median age was 55 [49-64] years and 311 (95.7%) were male; 70 (21.5%) were robust, 227 (69.8%) prefrail and 28 (8.6%) frail. Common components were low physical activity (36.6%), weight loss (33.2%) and slow gait (27.1%). In the frailty versus non-frailty model, higher PHQ-9 score (adjusted odds ratio [aOR] 1.12 per point, 95% confidence interval [CI] 1.04-1.21) and polypharmacy (aOR 3.34, 95% CI 1.23-9.10) were associated with frailty. In the prefrailty/frailty versus robust model, higher PHQ-9 score and body mass index were associated with the outcome. Sensitivity analyses yielded broadly consistent findings.

Prefrailty was highly prevalent, and frailty was associated with depressive symptoms and polypharmacy. Frailty at a median age of 55 years suggests clinically relevant vulnerability in Japanese people with HIV, although longitudinal and comparative studies are needed. These findings support integrated HIV care combining mental-health screening, medication review and physical-function assessment.