Factors associated with inspiratory muscle weakness in patients with HIV-1

Jerônimo, Fabiana Silva; Alves, Giovanni Nardin; Júnior, Gérson Cipriano; Vieira, Paulo José Cardoso; Chiappa, Adriana Meira Guntzel; Chiappa, Gaspar R.

doi:10.1016/j.bjid.2014.07.003

Cited by 5 publications

(8 citation statements)

References 43 publications

(77 reference statements)

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“…Our results also support those obtained in a study conducted with PLWHA, which observed an influence of CD4 lower than 200 cells / mm³ on inspiratory muscle strength and 6MWD (12). Like these authors, we agree that this is happens due to HIV infection, because the patients in our study had high viremia at the time of the first assessment, and HIV alone could have a negative influence on functional capacity in these individuals.…”

Section: Discussionsupporting

confidence: 92%

“…Some authors believe that in PLWHA systemic biochemical abnormalities may occur, resulting in inspiratory muscle dysfunction, with weakness of this musculature (12).The initial evaluation of our study found that 31.7% of patients had IMW and / or EMW, with lower than expected MIP and MEP values, respectively. MEP is intrinsically linked to respiratory muscle capacity, and reduced values of this pressure imply various physical and pulmonary conditions, including neuromuscular disorders (13).…”

Section: Discussionmentioning

confidence: 45%

“…Although ARVs have short-term adverse effects, the most characteristic ones appear in the long term and are related to their mitotoxicity (8). Studies have suggested a correlation between ART and the incidence of skeletal mitotoxicity (10), peripheral muscle weakness (dynapenia) (11), inspiratory muscle weakness (IMW) (12) and expiratory muscle weakness (EMW) (13). The decline in handgrip strength (HGS) may contribute to decreased life expectancy and worse quality of life with aging (14).…”

Section: Introductionmentioning

confidence: 99%

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Effect of Antiretroviral Therapy With Tenofovir, Lamivudine And Dolutegravir On Respiratory And Peripheral Muscles Strengh In People Living With Hiv/Aids

Cardoso

Araújo

Maranhão

et al. 2019

Preprint

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Background Some antiretrovirals (ARVs) cause muscle toxicity and their use has been attributed to beginning of respiratory and peripheral muscle weakness in people living with HIV/AIDS (PLWHA) on treatment. Dolutegravir (DTG) has been adopted by Brazil as a first-line regimen with Tenofovir/Lamivudine (TDF/3TC) since 2017, with low toxicity profile. Due to the short use of this regimen, we have not found data in the literature regarding its effects in the respiratory and peripheral muscles in PLWHA. The aim of this study was to compare respiratory and peripheral muscle strength before and after start of this new combined ART (TDF/3TC/DTG).Methods Descriptive, longitudinal and prospective study, observational and analytical with 41 PLWHA evaluated before the initiation of antiretroviral therapy (ART) (T0) which of these, 28 were reevaluated after more than 50 days of treatment (T1).The assessments of maximum functional capacity (six-minute walk test distance), maximal inspiratory (MIP) and expiratory (MEP) pressures and handgrip strength (HGS) were performed using standardized methods. In addition, laboratory data (CD4, CD4/CD8 ratio and viral load-VL) were collected. Shapiro-Wilk test was applied for normality while Fisher's exact test and t-test or Wilcoxon test were used for comparisons of categorical and continuous variables, respectively. Pearson or Spearman correlations were used according to data normality and p-value < 0.05 were considered significant for all analyzes.Results The frequency of peripheral muscle weakness in patients evaluated at T0 was 97.6%, while 31.7% had inspiratory and / or expiratory muscle weakness. HGS was positively correlated with CD4 (p = 0.027) and negatively correlated with VL (p = 0.046). Both MIP (p = 0.0176) and HGS (p = 0.0018) showed improvement in T1.Conclusion ART combined with TDF / 3TC / DTG increased MIP and HGS after more than 50 days of treatment. Cohort studies are needed to better understand the action of these medications on PLWHA musculature under treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

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Effect of Antiretroviral Therapy With Tenofovir, Lamivudine And Dolutegravir On Respiratory And Peripheral Muscles Strengh In People Living With Hiv/Aids

Cardoso

Araújo

Maranhão

et al. 2019

Preprint

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“…Alterações bioquímicas foram correlacionadas com a Tarv (ARNAUDO et al, 1991) e com o vírus HIV (DE SIMONE et al, 1992), podendo sugerir disfunções mitocondriais nesta população. Isso culminaria em diminuição de suplementação de energia necessária para contração da musculatura esquelética e, consequentemente, musculatura respiratória (JERÔNIMO et al, 2015). Também foram encontradas associações entre função pulmonar e risco cardiovascular em pacientes com HIV (PASSOS et al, 2012), mas até o momento não se teve relatos do envolvimento da força muscular respiratória com doença cardiovascular.…”

Section: Introductionunclassified

Influência Do Controle Virológico E Terapia Antirretroviral Na Força Muscular Respiratória Em Sujeitos Com Hiv

et al. 2020

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Objetivo: avaliar a influência do controle virológico e do uso de terapia antirretroviral (TARV) sobre a força muscular respiratória em pacientes com Human Immunodeficiency Virus (HIV). Métodos: estudo transversal com 60 sujeitos com HIV, de ambos os sexos, em uso da terapia antirretroviral há pelo menos três meses ou sem uso. Os indivíduos foram subdivididos em três grupos: com TARV e carga viral não detectável (GTCV-; n=20), com TARV e carga viral detectável (GTCV+; n=20) e sem TARV e carga viral detectável (GsTCV+; n=20). A força muscular respiratória foi mensurada com um manovacuômetro digital e os valores preditos das pressões respiratórias máximas calculados pela equação de Neder et al, 1999. Considerou-se fraqueza muscular inspiratória valores de pressão inspiratória máxima (PImáx) <70% do predito. Resultados: a carga viral foi menor no GTCV+ do que no GsTCV+. A contagem de células T-CD4 foi maior no GTCV- do que nos demais. Os grupos GTCV+ (60,5 [37,1-70,5]cmH2O) e GsTCV+ (67,9 [50,3-93]cmH2O, p<0,004) apresentaram redução da pressão expiratória máxima (PEmáx) na comparação com o GTCV- (100,2 [71-121,9]cmH2O), baseado no % do predito. Tanto o GTCV+ quanto o GsTCV+ apresentaram valores de mediana que demonstram fraqueza muscular inspiratória. Conclusões: o grupo de pacientes em uso da TARV e com carga viral não detectável apresentou maior força muscular expiratória e não foi classificado com fraqueza muscular inspiratória. Estes efeitos favoráveis da TARV e da baixa carga viral podem implicar em melhores desfechos funcionais, que devem ser testados em futuros trabalhos.

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“…In comparison, Beans et al (2013) found no difference in 6MWT findings of men who were HIV positive compared to men who were HIV negative when participants had similar comorbidities and demographic profiles. Factors known to influence 6MWT distance walked in PLWH include inspiratory muscle weakness (Jerônimo et al 2015); older age, current smoking status airflow limitations (Campo et al 2014); peak oxygen utilisation (VO 2 peak) (Beans et al 2013; Oliveira et al 2018; Oursler et al 2009) and active pulmonary tuberculosis (PTB) co-infection (Pontororing et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with physical function capacity in an urban cohort of people living with the human immunodeficiency virus in South Africa

Roos

Myezwa

Aswegen

2019

S. Afr. j. physiother.

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Background: Effective disease management for people living with human immunodeficiency virus (PLWH) includes the encouragement of physical activity. Physical function capacity in PLWH may be influenced by a variety of factors.Objectives: This study describes the physical function capacity as assessed with the 6-minute walk test (6MWT) of an urban cohort of PLWH and determined whether a history of pulmonary tuberculosis (PTB), anthropometric measures, age and gender predicted distance walked.Method: Secondary data collected from 84 PLWH on antiretroviral therapy were analysed. Information included 6MWT distance, anthropometric measurements and demographic profiles. Descriptive and inferential statistics were undertaken on the data. A regression analysis determined predictive factors for 6MWT distance achieved. Significance was set at a p-value of ≤ 0.05.Results: The study consisted of 66 (78.6%) women and 18 (21.4%) men with a mean age of 39.1 (± 9.2) years. The 6MWT distance of the cohort was 544.3 (± 64.4) m with men walking further (602.8 [± 58.6] m) than women (528.3 [± 56.4] m); however, women experienced greater effort. The majority of the sample did not report a history of PTB (n = 67; 79.8%). Age, gender and anthropometric measures were associated with 6MWT distance, but of low to moderate strength. The regression equation generated included age and gender. This model was statistically significant (p 0.00) and accounted for 34% of the total variance observed.Conclusion: Age and gender were predictive factors of physical function capacity and women experienced greater effort.Clinical implications: This study provides information on the physical function capacity of PLWH and a suggested 6MWT reference equation for PLWH in South Africa.

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Factors associated with inspiratory muscle weakness in patients with HIV-1

Abstract: patients with IMW+ had lower distance on the six-minute walk test in comparison to the IMW- group. The duration of highly active antiretroviral therapy, distance traveled on the 6MWT and CD4 count were determinants of IMW in patients with HIV.

Cited by 5 publications

References 43 publications

Effect of Antiretroviral Therapy With Tenofovir, Lamivudine And Dolutegravir On Respiratory And Peripheral Muscles Strengh In People Living With Hiv/Aids

Effect of Antiretroviral Therapy With Tenofovir, Lamivudine And Dolutegravir On Respiratory And Peripheral Muscles Strengh In People Living With Hiv/Aids

Influência Do Controle Virológico E Terapia Antirretroviral Na Força Muscular Respiratória Em Sujeitos Com Hiv

Factors associated with physical function capacity in an urban cohort of people living with the human immunodeficiency virus in South Africa

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