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

Research output: Contribution to journalArticlepeer-review

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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