The Impact of Frailty on All-Cause Mortality in Patients with HIV Infection: A Systematic Review and Meta-Analysis

AIDS Res Hum Retroviruses. 2022 Sep;38(9):692-699. doi: 10.1089/AID.2021.0155. Epub 2022 Aug 1.


The aim of this study was to conduct a systematic review and meta-analysis of cohort studies that have examined the association between frailty and all-cause mortality in patients with HIV infection. We searched Embase, Medline through the Ovid interface, PubMed, Cochrane Library, and Web of Science to identify potential studies. Cohort studies of death outcomes in HIV patients under debilitating conditions were included and other ineligible or inadequate data were excluded. Data related to all-cause mortality in patients with HIV were extracted. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for cohort studies. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were pooled to estimate the association between frailty and all-cause mortality using Stata, version 12.0. We identified 845 unduplicated citations. Of these, six cohort studies were eligible for inclusion in the review after applying our inclusion and exclusion criteria. Pooled results demonstrated that patients with HIV experiencing frailty were at an increased risk of all-cause mortality (pooled HR = 2.69, 95% CI = 1.83-3.97, p < .001) compared with those without frailty. Frailty was significantly associated with an increased risk of all-cause mortality among patients with HIV, indicating that frailty is an important predictor of adverse clinical outcomes. Therefore, more attention should be paid to screen patients with HIV for frailty and adopt appropriate interventions and personalized treatment plans to prevent the occurrence of adverse events. However, these results need to be validated in further prospective cohort studies in ethnically or geographically diverse populations.

Keywords: HIV; all-cause mortality; frailty.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Frail Elderly
  • Frailty* / complications
  • HIV Infections* / complications
  • Humans
  • Prospective Studies