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Purpose of review: This review conceptualizes multimorbidity and functional status impairment in people living with HIV and their implication in clinical and research fields.

Recent findings: Multimorbidity is an increasing age-related condition whose prevalence is higher in HIV-infected patients compared with the general population. It portrays the contemporary clinical complexity of HIV care. Whether multimorbidity describes an accelerated or accentuated aging process is the matter of discussion, although some HIV variables depicting immune activation and chronic inflammation are associated with multimorbidity. Multimorbidity coupled with functional status impairment are determinants of a frailty phenotype and in the frailty research setting, multimorbidity can be explored as an endpoint for clinical studies.

Summary: The success of highly active antiretroviral therapy has significantly changed the clinical pattern of HIV infection, with the 'greying' of the HIV-infected population testament to its success. This has provided new challenges relating to the care of older patients, particularly with regard to the management of multimorbidity functional status impairment.

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