Comparison of Functional Status Instruments in HIV-Infected Adults on Effective Antiretroviral Therapy

Erlandson, Kristine M.; Allshouse, Amanda A.; Jankowski, C.M.; Duong, Syki; MaWhinney, Samantha; Kohrt, Wendy M.; Campbell, Thomas

doi:10.1310/hct1306-324

Cited by 100 publications

(133 citation statements)

References 37 publications

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“…We reported a 8% lower 6-MW distance in 32 older HIV-infected men and a moderate correlation between the 6-MW distance and VO2peak [13]. Erlandson et al recently showed a 62% agreement between the LDCW and short physical performance battery (SPPB) in assessment of physical function, but did not include exercise testing [14]. These studies are limited by lack of a HIV uninfected comparison group.…”

Section: Introductionmentioning

confidence: 63%

“…First, the results highlight the importance of a HIV uninfected comparison group when investigating non-HIV related outcomes. Several recent functional performance studies, showed reduced 6-MW distance [10,13,19] or LCDW time [14] in HIV-infected adults using normative data. In this study we found no significant difference in the 6-MW distance between HIV-infected on successful ART and uninfected men with similar age-related comorbidity, even with adjustment for BMI.…”

Section: Resultsmentioning

confidence: 99%

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Ambulatory Function in Men with and without HIV Infection: Association with Cardiorespiratory Fitness

Stevenson¹

2013

J AIDS Clin Res

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Section: Introductionmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 99%

Ambulatory Function in Men with and without HIV Infection: Association with Cardiorespiratory Fitness

Stevenson¹

2013

J AIDS Clin Res

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“…Worse physical function was associated with non-HIV-related comorbidities in studies conducted predominantly in HIVinfected men, 13,17,19,20 although not in a study predominantly of women.…”

mentioning

confidence: 81%

Relationship Between Poor Physical Function, Inflammatory Markers, and Comorbidities in HIV-Infected Women on Antiretroviral Therapy

Baranoski

Harris

Michaels

et al. 2014

Journal of Women's Health

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Background: HIV-infected individuals may be at increased risk of poor physical function. Chronic inflammation has been associated with decreased physical function in the elderly and may also influence physical function in HIV-infected individuals. Methods: This cross-sectional study assessed physical function in 65 HIV-infected women aged 40 and older on stable antiretroviral treatment using the Short Physical Performance Battery (SPPB): a standardized test of balance, walking speed, and lower-extremity strength developed for elderly populations. The relationship between low SPPB score, selected demographic and medical characteristics, and high inflammatory biomarker profile was analyzed using Fisher's exact test and Wilcoxon rank sum test. Results: The median age of subjects was 49 years (interquartile range [IQR] 45-55), and the median CD4 T-cell count was 675 cells/mm 3 (IQR 436-828). Thirteen subjects (20%) had a low SPPB score. Subjects with a low SPPB score were more likely to be cigarette smokers ( p = 0.03), had more medical comorbidities ( p = 0.01), and had higher levels of interleukin-6 (IL-6) ( p < 0.05). They also tended to be older (median age 55 vs. 48, p = 0.06), more likely to have diabetes ( p = 0.07), and have higher levels of soluble tumor necrosis factor-1 ( p = 0.09). Conclusions: Twenty percent of women aged 40 and older with well-treated HIV had poor physical-function performance, which was associated with the high burden of comorbidities in this population and with increased IL-6. However, it is unclear from this cross-sectional study whether increased inflammation was related to poor physical function or to other factors, such as age and medical comorbidities.

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“…[23][24][25] Briefly, individuals with HIV-1 infection on antiretroviral therapy for a minimum of 6 months and no plasma HIV-1 RNA >200 copies/ml within the prior 6 months underwent physical function testing by the Short Physical Performance Battery and Fried's frailty assessment. Cases with low physical function, defined by a combination of deficits on both functional assessments, 23 were matched by age, gender, and time since HIV diagnosis to controls with high physical function (no deficits on either functional assessment).…”

Section: Study Populationmentioning

confidence: 99%

Physical Function Impairment of Older, HIV-Infected Adults Is Associated with Cytomegalovirus Immunoglobulin Response

Erlandson

Allshouse

Rapaport

et al. 2015

AIDS Research and Human Retroviruses

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Cytomegalovirus (CMV) is associated with poor outcomes, including physical function impairment, in older HIV-uninfected adults. Whether CMV is associated with physical functional impairment in HIV-infected adults is unknown. The primary objective of this study was to determine the relationship between CMV-specific humoral and cell-mediated immune responses with functional impairment in well-controlled HIV infection. In a case-control study, low-function cases were matched by age, gender, and time from HIV diagnosis to highfunction controls. Quantitative CMV IgG and %CMV-specific CD8 + and CD4 + T cells (interferon-c expression following CMV pp65 stimulation) were used to estimate physical function. Among 30 low-function cases and 48 high-function matched controls, CMV IgG ranged from <10 to 8,830 EU/ml, including four controls with results <10 EU/ml. Each log 10 increase in CMV IgG was associated with 5-fold greater odds of low function ( p = 0.01); these findings were robust to adjustment for concomitant CD4 + count, tobacco use, and age; to exclusion of subjects with CMV IgG <10 EU/ml; and to adjustment for hepatitis C viremia. %CMV-specific CD4 + or CD8 + T cells were not associated with low function. In bivariable models, the relationship between CMV IgG and physical function was attenuated and was no longer significant when including IL-6, CD4/CD8 ratio, or the Veterans Aging Cohort Study Index score. High levels of CMV-specific IgG were associated with impaired physical function. Attenuation of the strength of this association in bivariable models suggests an indirect relationship mediated by systemic inflammation and immune suppression.

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Comparison of Functional Status Instruments in HIV-Infected Adults on Effective Antiretroviral Therapy

Cited by 100 publications

References 37 publications

Ambulatory Function in Men with and without HIV Infection: Association with Cardiorespiratory Fitness

Ambulatory Function in Men with and without HIV Infection: Association with Cardiorespiratory Fitness

Relationship Between Poor Physical Function, Inflammatory Markers, and Comorbidities in HIV-Infected Women on Antiretroviral Therapy

Physical Function Impairment of Older, HIV-Infected Adults Is Associated with Cytomegalovirus Immunoglobulin Response

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