Long-term impact of HIV wasting on physical function

Kristine M. Erlandson*, Xiuhong Li, Alison G. Abraham, Joseph B. Margolick, Jordan E. Lake, Frank J. Palella, Susan L. Koletar, Todd T. Brown

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

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 languageEnglish (US)
Pages (from-to)445-454
Number of pages10
JournalAIDS
Volume30
Issue number3
DOIs
StatePublished - Jan 28 2016

Keywords

  • Aging
  • Falls
  • Frailty
  • HIV
  • Sarcopenia
  • Wasting

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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