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BackgroundIt has been previously demonstrated that intestinal barrier damage is one of the underlying mechanisms leading to frailty in non-HIV-infected aging populations. However, there is a paucity of direct evidence which demonstrates the association between intestinal barrier damage and frailty in people living with HIV (PLWH).MethodsThe present study is a retrospective case control study. Participants older than 50 years old were stratified into a frail/pre-frail group (case group) and non-frail group (control group) according to the Fried frailty phenotype. We collected and curated data concerning socio-demographic variables, psychological states and social functioning, and clinical information associated with the identification of biomarkers of intestinal barrier damage, microbial translocation, and levels of inflammatory cytokines of participants.ResultsThe case group had significantly higher levels of Reg-3α (p=0.042) and I-FABP (p=0.045) compared to the control group. We further observed, after adjusting for confounding factors by logistic regression analysis, that I-FABP levels remained significantly higher in the case group compared to the control group (p=0.033). Also, Fried Phenotype scores positively correlated with I-FABP levels (rs=0.21, p=0.01), LPS levels (rs=0.20, p=0.02), and sCD14 levels (rs=0.18, p=0.04). Moreover, the study confirmed both the positive correlation between inflammatory cytokines (IL-6 and IP-10) with frailty in aging PLWH, and between inflammatory cytokines (IL-6, IL-8 and IP-10) with biomarkers of intestinal barrier dysfunction in older PLWH.ConclusionThe present study indicates that the inflammation induced by intestinal barrier damage/dysfunction is likely to contribute to frailty in aging PLWH.
BackgroundIt has been previously demonstrated that intestinal barrier damage is one of the underlying mechanisms leading to frailty in non-HIV-infected aging populations. However, there is a paucity of direct evidence which demonstrates the association between intestinal barrier damage and frailty in people living with HIV (PLWH).MethodsThe present study is a retrospective case control study. Participants older than 50 years old were stratified into a frail/pre-frail group (case group) and non-frail group (control group) according to the Fried frailty phenotype. We collected and curated data concerning socio-demographic variables, psychological states and social functioning, and clinical information associated with the identification of biomarkers of intestinal barrier damage, microbial translocation, and levels of inflammatory cytokines of participants.ResultsThe case group had significantly higher levels of Reg-3α (p=0.042) and I-FABP (p=0.045) compared to the control group. We further observed, after adjusting for confounding factors by logistic regression analysis, that I-FABP levels remained significantly higher in the case group compared to the control group (p=0.033). Also, Fried Phenotype scores positively correlated with I-FABP levels (rs=0.21, p=0.01), LPS levels (rs=0.20, p=0.02), and sCD14 levels (rs=0.18, p=0.04). Moreover, the study confirmed both the positive correlation between inflammatory cytokines (IL-6 and IP-10) with frailty in aging PLWH, and between inflammatory cytokines (IL-6, IL-8 and IP-10) with biomarkers of intestinal barrier dysfunction in older PLWH.ConclusionThe present study indicates that the inflammation induced by intestinal barrier damage/dysfunction is likely to contribute to frailty in aging PLWH.
The epidemic of Human Immunodeficiency Virus (HIV) infection affects all social groups of the population. Biopsychosocial stressors directly related to HIV infection, such as stigma, discrimination and shame, side effects of treatment, symptoms of HIV infection, and disclosure of the diagnosis influence the deterioration of mental health of people living with HIV. Stigma and discrimination can prevent the timely seeking of psychiatric help. Social stigmatization of HIV infection may affect their adherence to antiretroviral therapy. The purpose of our study was to study the formation mechanisms of mental disorders in people living with HIV. A comprehensive examination of 118 patients diagnosed with HIV infection between the ages of 22 and 61 was conducted at the Sumy Regional Clinical Medical Center for Socially Dangerous Diseases. During the examination of each patient, a psychiatric examination was carried out, anamnestic data were collected, and questionnaires were used: the Symptom Check List90-Revised psychopathological symptoms questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI). The examined patients were diagnosed with organic mood disorders, depressive disorders, anxiety disorders; disorders related to stress and trauma. The results of the questionnaires confirm the diversity and breadth of clinical symptoms found among those examined. 55.9% of patients had severe symptoms of psychological distress. 55.9% of the examined show symptoms of depression of varying severity. As a result of the study, the main parameters that influence the formation of mental disorders in people living with HIV were formed: socioeconomic factors, which are primarily represented by a low level of education and a fairly high level of unemployment, social isolation and the absence of family support, fear of stigmatization, the presence of harmful habits and stressful events and factors related to the detection of HIV infection. Keywords: antiretroviral therapy, depression, neuroinflammation, psychosocial factors.
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