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Observational Study
. 2016 Jan 28;30(3):445-54.
doi: 10.1097/QAD.0000000000000932.

Long-term impact of HIV wasting on physical function

Kristine M Erlandson  1 , Xiuhong Li, Alison G Abraham, Joseph B Margolick, Jordan E Lake, Frank J Palella Jr, Susan L Koletar, Todd T Brown
Affiliations
Observational Study

Long-term impact of HIV wasting on physical function

Kristine M Erlandson et al. AIDS. .

Erratum in

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.

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Conflict of interest statement

Conflicts of Interest: Dr. Todd Brown has served as a consultant to AbbVie, ViiV Healthcare, Merck, Gilead, Theratechnologies, and EMD-Serono. Dr. Kristine Erlandson has received research funding from Gilead Sciences, not related to this project. Dr. Jordan Lake has served as a consultant to Gilead Sciences and GlaxoSmithKline.

Figures

Figure 1
Figure 1
Probability of survival with or without the presence of wasting among all participants of the Multicenter AIDS Cohort Study.
Figure 2
Figure 2. Change in body weight between wasting and function and functional outcome measures
Unadjusted means (dots) and 95% confidence limits (bars) of the change in body weight over the interval from wasting to functional outcome measures among HIV-infected men with a wasting history (left bars), HIV-infected men with no wasting history (center bars), and HIV-uninfected men (right bars).
Figure 3
Figure 3. Adjusted functional outcome measures
Adjusted means (dots) and 95% confidence limits (bars) of grip strength (panel A), gait speed (panel B), physical component summary score (panel C), and mental component summary score (panel D) among HIV-infected men with a history of wasting (left bars), HIV-infected men with no history of wasting (center bars), and HIV-uninfected men (right bars) from multiple linear regression models adjusting for age, race, HCV-infection, comorbidities and cohort enrollment.
See this image and copyright information in PMC

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