The interplay between frailty and intrinsic capacity in aging and HIV infection

In the context of an emerging aging epidemic affecting people living with HIV (PLWH), we critically discuss existing data regarding two different conceptual models of aging - frailty and intrinsic capacity respectively, both in a clinical and public health perspective. These constructs have not yet been integrated in the general population. Nevertheless, the holistic HIV care, that goes beyond the viro-immunological success, may offer an ideal setting to test a possible integration of these models in older adults living with HIV. We suggest a new framework to assess health in PLWH, shifting from an infectious diseases (ID)/internal medicine approach, which includes quality of life in the definition of healthy living with HIV, to an ID/geriatric medicine approach, focused on the maintenance of functional ability in frail and geriatric PLWH.