Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun 29;12(6):e0179874.
doi: 10.1371/journal.pone.0179874. eCollection 2017.

Diminished physical function in older HIV-infected adults in the Southeastern U.S. despite successful antiretroviral therapy

Audrey L Khoury  1 , Miriam C Morey  2   3 , Tammy C Wong  1 , Donna Lynn McNeil  4 , Barlett Humphries  5 , Katherine Frankey  5 , Carl F Pieper  2   6 , Charles B Hicks  7 , Kim Huffman  2   8 , Mehri S McKellar  2   9
Affiliations

Diminished physical function in older HIV-infected adults in the Southeastern U.S. despite successful antiretroviral therapy

Audrey L Khoury et al. PLoS One. .

Abstract

Background: As antiretroviral therapy efficacy improves, HIV is gradually being recognized more as a chronic disease within the aging HIV-infected population. While these individuals are surviving into old age, they may, however, be experiencing "accelerated aging" with greater declines in physical function than that observed among comparably matched individuals free of HIV. This decline is not well understood and it remains unclear if physical decline correlates with the degree of immunosuppression based on CD4 lymphocyte nadir.

Methods: In a cross-sectional study of accelerated aging in the older HIV-infected population on antiretroviral therapy (ART), physical performance evaluations were completed on a cohort of 107 HIV-infected subjects, age 50 years or older (with no HIV-1 RNA >200 copies/mL in the prior 12 months), and compared to reference ranges for age- and gender-matched HIV-uninfected persons. Physical performance testing consisted of four validated assessments: the 2.4-meter walk, 30-second chair stand, grip strength and 6-minute walk test.

Results: When compared to age- and gender-matched HIV-uninfected reference controls, older HIV-infected persons had diminished physical function. No correlation was found between physical function and degree of immunosuppression as determined by pre-ART CD4 nadir.

Conclusions: Despite improved survival, HIV-infected adults on suppressive ART have diminished physical function compared to HIV-uninfected persons. The degree of HIV-associated immunosuppression does not correlate with the observed degree of physical function decline in older HIV-infected persons, suggesting the decline is mediated by other mechanisms.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: We have read the journal's policy, and the authors of this manuscript have the following competing interests: Charles B. Hicks, M.D. is on the scientific advisory board for Janssen Virology, Merck, Gilead, and ViiV and on the data monitoring board for Medimmune. He receives royalties from UpToDate, Inc. and is an editorial staff/author for Journal Watch/ID. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials. The remaining authors have declared that no competing interests exist for them.

References

    1. Centers for Disease Control and Prevention. Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas, 2007–2010 [Internet]. HIV Surveillance Supplemental Report 2013;18(3). Available from http://www.cdc.gov/hiv/pdf/statistics_2010_hiv_surveillance_report_vol_1....
    1. Greene M, Justice AC, Lampiris HW, Valcour V. Management of human immunodeficiency virus infection in advanced age. JAMA-J Am Med Soc. 2013;309(13):1397–1405. - PMC - PubMed
    1. Capeau J. Premature aging and premature age-related comorbidities in HIV-infected patients: facts and hypotheses. J Clin Infect Dis. 2011:53(11):1127–1129. - PubMed
    1. Erlandson KM, Allshouse AA, Jankowski CM, Lee EJ, Rufner KM, Palmer BE, et al. Association of functional impairment with inflammation and immune activation in HIV type 1–infected adults receiving effective antiretroviral therapy. J Infect Dis. 2013;208(2):249–259. doi: 10.1093/infdis/jit147 - DOI - PMC - PubMed
    1. Erlandson KM, Allshouse AA, Jankowski CM, MaWhinney S, Kohrt WM, Campbell TB. Functional impairment is associated with low bone and muscle mass among persons aging with HIV-infection. J Acquir Immune Defic Syndr. 2013;63(2):209–215. doi: 10.1097/QAI.0b013e318289bb7e - DOI - PMC - PubMed

Substances