Assessment of Regional Body Composition, Physical Function and Sarcopenia among Peruvian women aging with HIV

Abstract

Background Management of chronic conditions and optimization of overall health has become a primary global health concern in the care of people living with HIV, particularly in lower-and-middle income countries where infrastructure for chronic disease management may be fragmented. Alterations in body composition (BC) can reflect important changes in musculoskeletal health, particularly among populations at risk for developing fat and muscle redistribution syndromes, such as HIV-infected women. We aimed to explore this issue among Peruvian women aging with HIV. Methods Cross-sectional study among HIV-infected and uninfected Peruvian women aged >=40. Dual X-ray absorptiometry was used to measure trunk and limb lean mass (LM) and fat mass (FM). Physical performance was assessed with the Short Physical Performance Battery (SPPB) and physical strength with a dynamometer. Sarcopenia was assessed based upon EWGSOP criteria. We used linear regression to model associations between BC, sarcopenia and physical scores. Results 104 HIV-infected and 212 uninfected women were enrolled with a mean age of 55.1±8.8 years. Among the HIV-infected group, years since diagnosis was 11.8±6 and all were on antiretroviral treatment. Mean SPPB score was 9.9 vs 10.8 (p<0.001) between both groups. Sarcopenia spectrum was found in 25.9% of HIV-infected and 23.1% of uninfected women. In multivariate regression analysis, trunk FM and older age were negatively correlated with physical performance among HIV-infected women. An increased percentage of severe sarcopenia was found among the HIV-infected, although our study was not specifically powered for this comparison. Conclusions HIV-infected women had significantly lower SPPB scores compared to women without HIV, and trunk FM and upper limb LM were independent predictors for the tests described. Prospective studies are needed in Latin America & the Caribbean to identify individuals at high risk for declines in physical function, and inform prevention guidelines.