High Prevalence of Sarcopenia in HIV-Infected Individuals

Abstract

Background Sarcopenia is a geriatric syndrome that leads to a loss of functionality and mortality. Methods We assessed the prevalence of sarcopenia in HIV-infected patients attended in our HIV Unit who had at least two DXA scans from 2000 to 2016 (1,720 DXA scans from 860 individuals). Sarcopenia was determinate according to appendicular skeletal muscle mass index (ASM) calculated as the ratio between skeletal muscle mass index (SMI) by DXA and height2 (kg/m2). We stratified patients by gender and age (<40, 41-50, and >50 years) and according to the interval between DXAs (≤3, 3-7, 7-10, >10 years). The statistical analysis was performed using SPSS version 19. Results Median (IQR) age was 52 (47; 57) years, and 76% were male. The median (IQR) time with HIV infection was 8 (3; 15) years. The prevalence of sarcopenia was 25.7% (95% CI, 22.8-28.7), more prevalent in those aged >50 years (27.8%). Stratifying by gender, 43% of women aged >50 years presented sarcopenia compared with 8.8% of men. The frequency of sarcopenia increased from 37.6% to 49.4% when interval between DXA was 7-10 years (n=109), significantly higher in women than in men (p=0.016). In addition to the traditional risk factors, time with HIV infection was associated with sarcopenia [RR 1.780 (95% CI, 1.314-2.411), p=0.001]. Conclusion The prevalence and progression of sarcopenia in HIV-infected patients were high, mainly among women. Further studies are necessary to assess the best approaches to prevent this condition and its consequences.

The Role of Physical Activity for the Management of Sarcopenia in People Living with HIV

“…Similarly, the prevalence of sarcopenia among 153 HIV-infected Asians was higher in those above 50 years of age compared to HIV-uninfected controls matched by age, sex and ethnicity (17% vs. 4%), but not significantly different when people below the age of 50 were included (10 vs. 6%) [33]. In a large Spanish cohort of PLWH assessed in the period 2000-2016, the overall prevalence of sarcopenia in those aged >50 years was 27.8%, with a different gender distribution, involving 43% of women and 8.8% of men [34].…”

“…Some of these studies also identified specific risk factors for sarcopenia in PLWH, in addition to traditional risk factors such as female gender, increasing age and high body mass index. These included low education level and employment status, long duration of HIV infection, low CD4 + T-cell counts at the start of cART and long-time exposure to certain nucleoside reverse transcriptase inhibitors (NRTIs), i.e., zidovudine, stavudine or didanosine [27,33,34]. Finally, specific health outcomes were also analysed in relation to the presence of sarcopenia, including mortality risk scores, quality of life, healthcare utilization, functional disability and falls.…”

Harvard HIV and Aging Workshop: Perspectives and Priorities from Claude D. Pepper Centers and Centers for AIDS Research

“…63,64 The rate of decline in muscle mass over a 5-year study period was similar in PWH and controls, 64 yet the frequency of sarcopenia increased over a 7-to 10-year follow-up in PWH older than 50 years with the progression of sarcopenia greater in women than men. 63 Standardized physical performance measures allow early detection and assessment of physical function impairments, as well as assess the effects of interventions aimed at averting physical decline and preventing mobility disability. Going beyond traditional research regarding muscle mass in PWH, we can learn more about the skeletal muscle specifically cellular and enzymatic activity changes that transpire with the use of skeletal muscle biopsies.…”

Sarcopenia in people living with the Human Immunodeficiency Virus: a systematic review and meta-analysis

“…Distinct from HIV wasting syndrome (characterized by overall body weight loss and diarrhea), sarcopenia is a progressive and generalized skeletal muscle disorder, and defined as a loss of both muscle mass and muscle function [8]. Some recent studies have demonstrated an increased presence of sarcopenia among PLHIV [9,10].…”