title: Physical fitness in children infected with the human immunodeficiency virus: associations with highly active antiretroviral therapy.
abstract: Obesity, sedentary lifestyles, and antiretroviral therapies may predispose HIV-infected children to poor physical fitness. Estimated peak oxygen consumption (VO(2) peak), maximal strength and endurance, and flexibility were measured in HIV-infected and uninfected children. Among HIV-infected children, anthropometric and HIV disease-specific factors were evaluated to determine their association with VO(2) peak. Forty-five HIV-infected children (mean age 16.1 years) and 36 uninfected children (mean age 13.5 years) participated in the study. In HIV-infected subjects, median viral load was 980 copies/ml (IQR 200-11,000 copies/ml), CD4% was 28% (IQR 15-35%), and 82% were on highly active antiretroviral therapy (HAART). Compared to uninfected children, after adjusting for age, sex, race, body fat, and siblingship, HIV-infected children had lower VO(2) peak (25.92 vs. 30.90 ml/kg/min, p<0.0001), flexibility (23.71% vs. 46.09%, p=0.0003), and lower-extremity strength-to-weight ratio (0.79 vs. 1.10 kg lifted/kg of body weight, p=0.002). Among the HIV-infected children, a multivariable analysis adjusting for age, sex, race, percent body fat, and viral load showed VO(2) peak was 0.30 ml/kg/min lower per unit increase in percent body fat (p<0.0001) and VO(2) peak (SE) decreased 29.45 (± 1 .62), 28.70 (± 1.87), and 24.09 (± 0.75) ml/kg/min across HAART exposure categories of no exposure, <60, and ≥ 60 months, respectively (p<0.0001). HIV-infected children had, in general, lower measures of fitness compared to uninfected children. Factors negatively associated with VO(2) peak in HIV-infected children include higher body fat and duration of HAART ≥ 60 months. Future studies that elucidate the understanding of these differences and mechanisms of decreased physical fitness should be pursued.
authors: Divisions of Pediatric Clinical Research, University of Miami, Miami, FL 33101, USA.
authors: Gabriel
authors: G
authors: Somarriba
authors: Gabriela
authors: G
authors: Lopez-Mitnik
authors: David A
authors: DA
authors: Ludwig
authors: Daniela
authors: D
authors: Neri
authors: Natasha
authors: N
authors: Schaefer
authors: Steven E
authors: SE
authors: Lipshultz
authors: Gwendolyn B
authors: GB
authors: Scott
authors: Tracie L
authors: TL
authors: Miller
mesh_terms: D000293:Adolescent; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000187:drug effects / Q000502:physiology; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology; D010807:Physical Endurance / Q000187:drug effects / Q000502:physiology; D010809:Physical Fitness; D019562:Viral Load; D055815:Young Adult