There is limited evidence about the long-term changes in nutritional status among the elderly people living with human immunodeficiency virus (PLWH). We aimed to investigate the changes in nutritional status and related factors over 4 years in the elderly PLWH. The longitudinal study was conducted prospectively among 250 PLWH, 50 years of age and older, receiving antiretroviral therapy (ART). The Mini Nutritional Assessment (MNA) and Thai Depression Scale (TDS) to assess nutritional status and depression, respectively, were performed at the outpatient clinic both at baseline and 4-year follow-up. Majority were male (60.8%) with median age of 58 years. The median CD4 was 612.5 cells/mm³ and 98% had HIV RNA <50 copies/mL. Median duration of ART was 20 years. Median body mass index was 23.1 kg/m². The most common ART were rilpivirine (45.2%) and dolutegravir (18.8%). Fifty-one patients (20.4%) deteriorated in nutritional status and mean MNA scores declined (25.8 vs. 24.8, p < .001) at follow-up period. In multivariate analysis, high TDS scores (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.17–1.52), polypharmacy (OR, 1.35; 95% CI, 1.10–1.65), and high-density lipoprotein cholesterol (HDL-C) levels (OR, 1.04; 95% CI, 1.01–1.07) were associated factors of deterioration in nutritional status. In this 4-year longitudinal follow-up, 20% of the aging PLWH have deterioration of nutritional status. High TDS scores (depression), polypharmacy, and high HDL-C were significantly associated with declining nutritional status. Our findings highlight the importance of screening and monitoring nutritional and depression status in routine HIV treatment and care for geriatric HIV-infected population.

中文翻译：

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亚洲老年艾滋病毒感染者营养状况恶化及其与抑郁症的负相关关系：一项为期四年的纵向研究

关于感染人类免疫缺陷病毒 (PLWH) 的老年人营养状况长期变化的证据有限。我们旨在调查 4 年内老年 PLWH 营养状况及相关因素的变化。纵向研究在 250 名 50 岁及以上接受抗逆转录病毒治疗 (ART) 的 PLWH 中前瞻性地进行。迷你营养评估 (MNA) 和泰国抑郁量表 (TDS) 分别在基线和 4 年随访时在门诊进行评估营养状况和抑郁症。大多数为男性（60.8%），中位年龄为 58 岁。CD4 中位数为 612.5 个细胞/mm ³，98% 的 HIV RNA <50 拷贝/mL。ART 的中位持续时间为 20 年。体重指数中位数为 23.1 kg/m ². 最常见的抗逆转录病毒疗法是利匹韦林（45.2%）和多替拉韦（18.8%）。51 名患者 (20.4%) 的营养状况恶化，平均 MNA 评分下降（25.8 对 24.8，p < .001) 在随访期间。在多变量分析中，高 TDS 评分（优势比 [OR]，1.33；95% 置信区间 [CI]，1.17-1.52），多药治疗（OR，1.35；95% CI，1.10-1.65）和高密度脂蛋白胆固醇(HDL-C) 水平 (OR, 1.04; 95% CI, 1.01–1.07) 是营养状况恶化的相关因素。在这 4 年的纵向随访中，20% 的老龄化 PLWH 营养状况恶化。高 TDS 评分（抑郁）、多种药物治疗和高 HDL-C 与营养状况下降显着相关。我们的研究结果强调了筛查和监测营养和抑郁状态在艾滋病毒感染者的常规治疗和护理中的重要性。