HIV infection is associated with lower physical performance, say the researchers in the online edition of Revista AIDS. It was also found that people living with HIV and reduced physical activity had a significant increase in their risk of death.
The study population consisted of patients seropositive for HIV in middle age and seronegative patients also in middle-aged people in Baltimore, United States, whether they were or not, injecting drug users (IDUs).
“Our results show the great impact of HIV disease on physical performance, support the growing recognition and importance of chronic HIV disease in middle age with the results and can inform and form strategies for the clinical management of aging in people infected with HIV. HIV ”, comment the authors.
Thanks to improvements in treatment and care for HIV-positive people, a large porçãocada increasingly growing of people living with HIV are chegandoa increasingly advanced ages. This means, in short, that the diseases of aging are, nowadays, a major cause of death in these patients; deaths can be avoided or at least postponed
Reduced physical activity is associated with a higher risk of mortality among the elderly compared to the general population. Depending on your lower body - balance, walking speed and difficulty getting up from a sitting position - this can be assessed using a short battery of physical performance tests (SPPB in English). In the general population, the SPPB score below ten is associated with an increased risk of impaired access to nursing care and mortality.
Using SPPB, researchers wanted to see whether carrying HIV could be associated with less physical function. They also wanted to see if performance
had an association with risk of mortality in people living with HIV / AIDS.
Thus, it assessed prospectively the physical performance and the risk of mortality in a cohort of HIV-positive 1627 current risk and former injection drug users. Physical performance was measured every six months. The follow-up study took place between the years 2005 and 2010, and participants contributed a total of 12.270 study visits.
The participants had an average age of 51 years, most african-Americans and a third made up of women.
Participants living with HIV contributed 3715 study visits (30%). The median CD4 count and viral load were 340 cells / mm3 and 70 copies / ml, respectively.
The SPPB scores with ten or fewer points accounted for a third of the study visits.
After taking into account possible confounding factors, HIV infection was independently associated with an increase of 30% risk of a SPPB score of ten or below (OR = 1,30, 95 -1,12 IC1.52%).
During the monitoring period, 165 patients (10%) died. This means that the death rate was 2,75 100 by person-years.
The SPPB Score of ten points or below was associated with a 2,3 point increase in the risk of mortality compared to a higher SPPB Score (HR 2,34; 95% CI 1,67 -3,27). For HIV-negative patients, SPPB with a lower score was associated with a 2.21-fold (95% CI, 1,37 -3,55) increase in the risk of mortality, compared with one between 2,55-fold (95 CI %, 1,33 -4.76) increase in HIV-positive patients to people with poorly controlled HIV, and the 2,02-fold (95% CI, 0,95 -4,3) increase in all other HIV positive individuals.
HIV infection alone was associated with almost three times more at risk of mortality (HR = 2,78, 95 -1,70 IC4.54%).
The authors found that the lower physical performance and HIV infection had a joint effect on the risk of mortality.
People living with HIV and who had low scores SPPB had a six-fold increase (HR = 6,03, 95 -3,80 IC10,0%) in the risk of death during follow-up period compared to HIV-negative individuals with higher SPPB score.
“Our findings reinforce the need to integrate the principles as a functional geriatric assessment for the care of HIV-infected elderly,” conclude the authors. "The SPPB score can be an effective tool for use in clinical research and in clinical / therapeutic settings to support the healthy aging of people with HIV infection."
Translated from original Reduced physical function Significantly Increases mortality risk of middle-aged people living with HIV by Cláudio Santos de Souza in 16 / 06 / 2015