The importance of muscle strength and physical performance as part of the diagnosis and management of sarcopenia in young adults living with human immunodeficiency virus

Objective:  To evaluate muscle functionality, physical performance and body composition in young people living with human immunodeficiency virus (PLWH).

Subjects and methods:  Eighty-one HIV-infected and 54 uninfected (20 to 50 years) male and female subjects were enrolled to participate. Patient evaluation included body composition by DXA (dual energy X-rays), SARC-F questionnaire, hand grip and timed up & go (TUG) tests.

Results:  Fifty PLWH and 50 age-gender matched controls completed the study. The median age was 40 (25-49) vs. 36.5 (22-50) for the HIV and control groups, respectively (p 0.120). Race, gender, body mass index, phosphorus and 25-hydroxyvitamin D were similar between groups. HDL-c was significantly lower in HIV-infected (p 0.006). Groups had similar body composition parameters, although more PLWH presented appendicular lean mass (ALM) and ALM adjusted to height (ALM/h²) below reference values (18% vs 4%). SARC-F questionnaire and TUG were significantly compromised in HIV-infected when compared to controls (p 0.001 and 0.005, respectively). Hand grip test was slightly lower in PLWH than in control group (29.0 kg (9.3-56.0) vs. 32.8 kg (13.3-57.3); p 0.052).

Conclusion:  Our results suggest that there is loss of functionality, physical performance and muscle strength in young PLWH. Therefore, screening using SARC-F, hand grip and TUG test might be interesting in HIV-infected which are considered at high-risk for sarcopenia. With early diagnosis there is the possibility of decreasing muscle dysfunction, morbimortality, providing an increase in quality of life and working hours.

Keywords:
Body composition; sarcopenia; muscle strength; appendicular lean mass; HIV