Abstract
Background: The long-term consequences of wasting among HIV-infected persons are not known. Design: HIV-infected men surviving ≥2 years based on Kaplan-Meier analysis after a clinical diagnosis or weight trajectory consistent with wasting and with available physical function assessment data [grip strength, gait speed, and quality of life (QoL)] were matched to HIV-infected and uninfected men without wasting. Methods: Matching criteria at the functional assessment included age, calendar year, and CD4+ T-cell count and plasma HIV-1 RNA (HIV-infected only). Multivariable linear regression analyses adjusted for age, cohort, race, hepatitis C status, and number of comorbid illnesses were used to assess the impact of wasting on subsequent physical function. Results: Among 85 HIV-infected men surviving ≥2 years after wasting, we evaluated physical function outcomes compared with 249 HIV-infected and 338 HIV-uninfected men with no historical wasting. In multivariable regression models, HIV-infected men with prior wasting had lower grip strength and poorer physical QoL than HIV-infected men with no wasting (P≤0.03), and poorer physical QoL, but higher mental QoL than HIV-uninfected men (P≤0.05). When controlling for measures of immune suppression (nadir CD4+ T-cell count/AIDS, the association between wasting and physical QoL was markedly attenuated, whereas there was minimal impact on the association between wasting and grip strength. Conclusions: HIV-infected wasting survivors had weaker grip strength compared with HIV-infected persons without wasting; immune suppression was associated only with physical QoL. HIV-infected survivors of wasting may represent a population of adults at increased risk for physical function decline.
Original language | English (US) |
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Pages (from-to) | 445-454 |
Number of pages | 10 |
Journal | AIDS |
Volume | 30 |
Issue number | 3 |
DOIs | |
State | Published - Jan 28 2016 |
Keywords
- Aging
- Falls
- Frailty
- HIV
- Sarcopenia
- Wasting
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases