Clinical Report: Frailty in HIV linked to inflammation, bone health, T-cell exhaustion

Overview

Frailty in individuals with HIV is associated with inflammatory proteins, altered bone health markers, and T-cell exhaustion. A study involving 120 participants revealed relationships between frailty and various plasma markers, particularly those related to NF-κB signaling.

Background

Frailty is increasingly recognized as a significant concern among individuals living with HIV, often manifesting earlier than in the general population. Understanding the underlying mechanisms, including inflammation and immune function, is crucial for managing health outcomes in this demographic.

Data Highlights

The study included 120 participants with HIV, with half meeting frailty criteria. Key findings included:

Key Findings

• 19 of 75 plasma markers were significantly associated with frailty, linked to NF-κB signaling.
• Frailty was characterized by lower proportions of naïve CD4 and CD8 T cells.
• Higher proportions of CD4 T cells expressed immune checkpoint molecules TIGIT and PD-1 in frail individuals.
• Osteoprotegerin (OPG) was the soluble marker most strongly linked to T-cell phenotypes among frail participants.
• OPG and tumor necrosis factor levels correlated with PD-1 expression and inversely with naïve CD4 T-cell phenotype.

Clinical Implications

The findings suggest that monitoring inflammatory markers and T-cell populations may be important in assessing frailty in individuals with HIV. Clinicians should consider these factors when developing care plans for aging patients with HIV.

Conclusion

This study underscores the complex interplay between inflammation, immune function, and frailty in individuals with HIV, warranting further investigation into causal relationships.

Related Resources & Content

1. Kristine M. Erlandson, The Journal of Infectious Diseases, 2026 -- Frailty in People with HIV Is Linked to Inflammation, Bone Health, and T-Cell Exhaustion
2. The Journal of Infectious Diseases, 2026 -- Increasing Handgrip Strength to Combat Frailty in Human Immunodeficiency Virus: Linking Immune Exhaustion to a Bone Health Indicator
3. Frontiers in Immunology, 2026 -- Immune cell senescence and chronic bone diseases: osteoimmune mechanisms and therapeutic perspectives
4. The Journal of Infectious Diseases, 2026 -- A Biomarker Profile Reflective of Preserved Thymic Function Is Associated With Reduced Comorbidities in Aging People With HIV: An AGEhIV Cohort Analysis
5. European AIDS Clinical Society guidelines 2025 - PMC, 2025 -- Major revision version 13.0
6. Frailty in People with HIV Is Linked to Inflammation, Bone Health, and T-Cell Exhaustion
7. Bone Quality Beyond DXA in People Living with HIV: A Systematic Review
8. Major revision version 13.0 of the European AIDS Clinical Society guidelines 2025 - PMC