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Evaluation of submaximal endurance in young children living with HIV
Joanne Potterton1, Renate Strehlau2, Stephanie Shiau3
1Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Children with perinatally acquired HIV on early antiretroviral therapy show similar submaximal endurance to their peers. Monitoring endurance and physical activity is crucial for these children, as levels may improve with age.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiopulmonary Health
Background:
- Long-term sequelae of perinatally acquired human immunodeficiency virus (HIV) are a growing concern.
- Children living with HIV (CLHIV) often exhibit cardiopulmonary impairments and reduced physical activity, potentially linked to poor endurance.
Purpose of the Study:
- To compare the sub-maximal endurance of CLHIV with a non-infected comparison group.
- To identify factors associated with endurance in CLHIV.
Main Methods:
- A cross-sectional descriptive study involving 346 children (ages 5-11 years): 175 CLHIV and 171 controls.
- Sub-maximal endurance assessed using the Six Minute Walk Test (6MWT).
- Physiological parameters (blood pressure, heart rate, oxygen saturation) and clinical/anthropometric data were recorded.
Main Results:
- No statistically significant differences in sub-maximal endurance were found between CLHIV and control groups (p=0.831).
- Early initiation of antiretroviral therapy (ART) and well-controlled viral load (<1000 copies/ml) were observed in the CLHIV group.
- In girls living with HIV, earlier ART initiation and stunted growth were negatively associated with 6MWT distance.
Conclusions:
- CLHIV initiating ART early with well-controlled disease achieve sub-maximal endurance levels comparable to their uninfected peers.
- Continued monitoring of endurance and physical activity is recommended for CLHIV.
- Sub-maximal endurance may improve with age and biological maturation in CLHIV.
Background:
There is growing concern about the long-term sequelae [a condition which is the consequence of a previous disease or injury] of perinatally acquired human immunodeficiency virus (HIV). Children living with HIV (CLHIV) present with cardiopulmonary impairments and decreased physical activity which may be due to poor endurance.
Objectives:
Our study aimed to investigate the sub-maximal endurance of CLHIV compared to a non-infected comparison group.
Methods:
In this cross-sectional descriptive study 346 CLHIV, between ages five and eleven years, were assessed using the Six Minute Walk Test (6MWT). Blood pressure, heart rate and oxygen saturation were measured pre-test, immediately post-test and five minutes post-test. Clinical and anthropometric data were recorded. Height and weight were assessed using a stadiometer and a digital scale, respectively.
Results:
175 CLHIV (52% female) and 171 children without HIV (46% female) participated. All children were Black African. The CLHIV all initiated antiretroviral therapy (ART) at a young age (mean 8.7 months, standard deviation 6.7) and their disease was well controlled (viral load < 1000copies/ml). There were no statistically significant differences in submaximal endurance between the two groups (p = 0.831). Age of starting ART and stunted growth were negatively associated (r = -2.8 (p = 0.019) and r = -46.1 (p = 0.027), respectively) with distance walked in the 6MWT by girls living with HIV.
Conclusion:
CLHIV who initiate ART early with well-controlled disease are able to attain submaximal endurance levels similar to their uninfected peers.
Clinical Implications:
Endurance and physical activity should be monitored in CLHIV. Submaximal endurance levels may improve with age and biological maturation.
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