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Muscle mass, strength, bone mineral density and vascular function in middle-aged people living with HIV vs.
Karynne Grutter Lopes1, Paulo Farinatti2, Gabriella de Oliveira Lopes3
1Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil; Laboratory for Clinical and Experimental Research on Vascular Biology, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil; Graduate Program in Clinical and Experimental Physiopathology, University of Rio de Janeiro State, Rio de Janeiro, Brazil.
Insights
Middle-aged individuals with HIV on combination antiretroviral therapy (cART) show similar muscle mass and strength to controls, but may experience accelerated bone density loss, approaching levels seen in older adults.
Area of Science:
- Gerontology
- Infectious Diseases
- Orthopedics
- Cardiology
Background:
- Combination antiretroviral therapy (cART) has improved longevity for people living with HIV (PLHIV).
- Prolonged HIV infection and cART are associated with increased risk of comorbidities, potentially accelerating age-related disorders.
- This study investigates the impact of long-term cART on muscle, bone, and vascular health in middle-aged PLHIV.
Purpose of the Study:
- To compare muscle mass, strength, bone mineral density (BMD), and vascular function in middle-aged PLHIV on cART versus age-matched and older controls.
- To assess potential acceleration of age-related comorbidities in PLHIV due to prolonged HIV infection and treatment.
Main Methods:
- Cross-sectional study involving 12 PLHIV on cART, 12 age-matched controls, and 12 older controls.
- Assessments included dual-energy X-ray absorptiometry for body composition and BMD, isokinetic dynamometry for muscle strength, and venous occlusion plethysmography for vascular function.
- Participants were carefully screened for secondary conditions and medications.
Main Results:
- Relative muscle mass and isokinetic strength were similar between PLHIV and age-matched controls, but significantly greater than in older controls.
- Total BMD was similar in PLHIV and older controls, and both groups had lower BMD than age-matched controls.
- No significant differences in macrovascular reactivity were observed across the three groups.
Conclusions:
- Middle-aged PLHIV on prolonged cART may experience accelerated age-related osteopenia, with BMD values comparable to older adults.
- Muscle mass, isokinetic strength, and vasodilation capacity remain preserved in PLHIV compared to age-matched uninfected individuals.
- Findings suggest a need for monitoring bone health in PLHIV undergoing long-term cART.
Introduction:
Combination antiretroviral therapy (cART) substantially extended the life of people living with HIV (PLHIV). However, prolonged HIV infection and cART increase the risk of comorbidities accelerating age-related muscle, bone, and vascular disorders. This cross-sectional study compared muscle mass and strength, bone mineral density (BMD), and vascular function in middle-aged PLHIV treated with cART vs. non-infected age-matched and older controls.
Methods:
After careful screening for secondary diseases and medications, body composition, muscular and vascular function were assessed in 12 PLHIV (43.9±8.7 yrs old; HIV-infection for 16.2±8.6 yrs; on cART for 11.6±9.2 yrs), 12 age-matched (CONT, 43.2±8.5 yrs old), and 12 older (OLDER, 74.4±8.3 yrs old) controls through dual x-ray absorptiometry, isokinetic dynamometry, and venous occlusion plethysmography, respectively.
Results:
PLHIV and CONT showed similar relative muscle mass (65.3±8.0 vs. 66.9±7.3%, respectively; P= 0.88) and strength (160.7±53.9 vs. 152.0±52.9 N.m-1, respectively; P= 0.90), which were greater than OLDER (80.6±18.8 N.m-1; P= 0.001). Total BMD was similar in PLHIV (1.04±0.13 g.cm-2) and OLDER (1.00±0.15 g.cm-2, P= 0.86), and both groups presented lower values than CONT (1.20±0.13 g.cm-2, P< 0.01). No significant difference across groups was detected for macrovascular reactivity (P= 0.32).
Conclusion:
Age-related osteopenia might be accelerated in middle-aged PLHIV on prolonged cART, as their BMD approached values found in older adults. On the other hand, muscle mass, isokinetic strength, and vasodilation capacity were similar in PLHIV and age-matched uninfected controls.
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