Does my mother’s frailty mean that the ARVS are not responding?

#AsktheDoctor 

Question: Dear Doctor, My mother, who is in her fifties, was diagnosed with HIV a year ago and started taking ARVs immediately. 

Her viral load is suppressed and she has been well but of late she likes to spend most of the time alone; claiming to be meditating but we have noticed she has become very frail, looks older than her age and most of her muscles are wasted. 

She also often falls when she tries to walk. What could be the problem? 

Angella

Answer: Dear Angella, Although the cardinal goal of putting people with HIV (PWH), like your mother, on antiretroviral drugs (ARVs) is to suppress the virus, HIV/AIDS care goes beyond providing ARVs. 

Your mother needs to be assessed by a mental health specialist because she is most likely depressed. 

Depression is the most common mental health challenge faced by PWH, followed by anxiety and substance use disorders such as alcoholism.

Therefore, all PWH should be targeted with mental health awareness and prevention programmes and those found to have mental health challenges when screened should be put on treatment early. 

Concerning her physical condition, it is important to note that one’s chronological age may not correspond to his or her biological or physiological age. 

Chronological age refers to the number of years one has been alive, while biological age refers to an individual’s physiological state and functionality. 

The frailty and wasting of muscles, a condition known as “sarcopenia,” comes with ageing and is influenced or made worse by a lack of activity and eating unhealthy diets instead of having a balanced diet. 

Sarcopenia can, therefore, be classified as a lifestyle condition similar to diabetes and cardiovascular conditions such as high blood pressure, which means one can avoid them or prevent them from happening earlier by the way one eats and lives. 

Although one can do nothing about chronological ageing, one can certainly influence how he or she ages biologically. Lastly, PWH like your mother may be prone to ageing faster biologically because of the chronic inflammation of the body cells caused by the virus.