Table 2.

Unadjusted and Adjusted Associations Between Demographics, Human Immunodeficiency Virus, Comorbidities and Frailty Status

		Univariablea (n = 1016)		Multivariablea (n = 867)
Variables		Odds ratio (95% CI)	P value	Odds ratio (95% CI)	P value
Sex	Female	1.87 (1.38–2.53)	<.001	1.23 (0.83–1.81)	.30
Race, vs white, non-Hispanic	Black, non-Hispanic	1.79 (1.35–2.38)	<.001	1.15 (0.81–1.64)	.43
	Hispanic + other	1.69 (1.24–2.31)	<.001	1.34 (0.86–2.08)	.19
Baseline age, vs 40–49	50–59	1.87 (1.43–2.45)	<.001	1.78 (1.29–2.44)	<.001
	≥60	1.89 (1.32–2.71)	<.001	1.48 (0.94–2.32)	.09
Education, vs >high school	≤High school	2.35 (1.82–3.02)	<.001	1.57 (1.13–2.17)	.007
Health insurance, vs Medicare/Medicaid	No coverage	0.58 (0.41–0.82)	.002	0.67 (0.44–1.04)	.07
	Private or other	0.31 (0.24–0.42)	<.001	0.58 (0.41–0.82)	.002
Baseline CD4 cell count, vs >500	<350	1.59 (1.10–2.3)	.01	1.52 (0.84–2.74)	.16
	350–500	0.86 (0.63–1.17)	.34	0.98 (0.67–1.43)	>.90
Pre-ART HIV RNA copies/mL, vs ≤100000	≥100000	0.78 (0.61–1.01)	.06	0.73 (0.53–1.00)	.05
Initial ART regimen, vs NRTI-backbone + PI	NRTI-backbone + NNRTI	1.35 (1.00–1.83)	.05	1.47 (1.02–2.11)	.04
	NRTI-backbone + INSTI	1.26 (0.83–1.90)	.28	1.02 (0.62–1.7)	>.90
	Other	1.14 (0.82–1.58)	.43	1.16 (0.78–1.71)	.46
Hepatitis C serology, vs never positiveb	Ever positive	1.74 (1.21–2.51)	.003	1.55 (1.01–2.38)	.05
History of smoking, current + prior	Never	1.44 (1.12–1.84)	.004	1.37 (1.01–1.86)	.04
Current alcohol use at baseline, vs nonec	Light	0.50 (0.38–0.67)	<.001	0.62 (0.44– 0.86)	.004
	Moderate/heavy	0.44 (0.31–0.61)	<.001	0.52 (0.35– 0.77)	.001
Days of vigorous/moderate activities/ week, vs ≥3	<3	2.10 (1.63–2.70)	<.001	1.95 (1.46–2.61)	<.001
Obesity at baselined		1.54 (1.18–2.01)	.001	1.42 (1.02–1.98)	.04
Obesity at ART initiationd		1.60 (1.16–2.20)	.004
Weight change within the first year of ART, kg	Every 1-kg increase	1.02 (1.00–1.04)	.02	1.01 (0.99–1.03)	.35
Cardiovascular disease		2.26 (1.38–3.72)	.001	1.52 (0.86–2.70)	.15
Renal diseasee		2.35 (1.58–3.48)	<.001	1.52 (0.97–2.40)	.07
Cancer within past 5 yearsf		2.01 (1.03–3.91)	.04	1.22 (0.53–2.81)	.65
Diabetesg		2.24 (1.59–3.15)	<.001	1.21 (0.79–1.85)	.39
Hypertensionh		1.47 (1.10–1.95)	.009	1.26 (0.87–1.82)	.22
Neuro-impairment at baseline		2.52 (1.80–3.52)	<.001	2.04 (1.37–3.03)	<.001

Bold indicates P value ≤0.05. Other covariates considered but not associated (P ≥ .10) with frailty in univariable models included: nadir CD4 count, baseline antiretroviral therapy (ART) regimen, years since ART initiation, any zidovudine use, any didanosine or stavudine use, cumulative integrase strand transfer inhibitor, protease inhibitor and nonnucleoside reverse transcriptase inhibitor use, substance use, weight change between A5001 entry and baseline, baseline low-density lipoprotein cholesterol, liver disease, and depression. Substance use included history of use of illicit substances, including tobacco. Liver disease was defined as cirrhosis, ascites, esophageal/gastric varices, or hepatic encephalopathy during A5001/parent studies, or as cirrhosis or hepatic steatosis on HAILO.

Depression was defined as current use of an antidepressant medication, an ongoing diagnosis of major depression, or grade 3 or greater major depression symptoms.

Abbreviations: ART, antiretroviral therapy; CI, confidence interval; INSTI, integrase strand transfer inhibitor; NNRTI, nonnucleoside reverse transcriptase inhibitor; NRTI, nucleoside/nucleotide reverse transcriptase inhibitor; PI, protease inhibitor.

^aOutcome modeled is an increase in 1 frailty level (from nonfrail to prefrail or prefrail to frail).

^bHepatitis C virus infection was defined as any positive hepatitis C antibody.

^cAlcohol use in the past 30 days was categorized as abstainer, light (men <7 drinks/week, women <3 drinks/week; no binge drinking), moderate (men 7–14 drinks/week, women 3–7 drinks/week; no binge drinking), or heavy use (men >14 drinks/week, women >7 drinks/week, and/or binge drinking). Binge drinking, ≥5 drinks for men and ≥4 drinks for women within a 2-hour period, was separately considered as abstainer, no binging, binging once/month, or binging more than once/month.

^dBMI was categorized as underweight (body mass index [BMI] < 18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25–30 kg/m²), and obese (>30 kg/m²).

^eRenal disease was defined as estimated glomerular filtration rate (eGFR) measurements <60 mL/min/1.73 m² measured at least 3 months apart with no intervening eGFR ≥60 based on the CKD-EPI equation.

^fCancer was defined as any malignancy within 5 years except nonmelanoma skin cancer.

^gDiabetes was defined as 2 consecutive nonfasting serum glucose measurements >200 mg/dL, 2 fasting glucoses ≥126 mg/dL within 1 year, a diagnosis of diabetes, or a hemoglobin A1C ≥6.5%.

^hHypertension was defined as use of antihypertensive medications, a diagnosis of hypertension, or a systolic blood pressure of ≥140 mm Hg or diastolic of ≥90 mm Hg at 2 consecutive visits.