title: Long-term impact of HIV wasting on physical function.
abstract: BACKGROUND
  The long-term consequences of wasting among HIV-infected persons are not known.
  
  
  METHODS
  HIV-infected men surviving ≥2 years based on Kaplan-Meier analysis after a clinical diagnosis or weight trajectory consistent with wasting and with available physical function assessment data [grip strength, gait speed, and quality of life (QoL)] were matched to HIV-infected and uninfected men without wasting.
  
  
  METHODS
  Matching criteria at the functional assessment included age, calendar year, and CD4 T-cell count and plasma HIV-1 RNA (HIV-infected only). Multivariable linear regression analyses adjusted for age, cohort, race, hepatitis C status, and number of comorbid illnesses were used to assess the impact of wasting on subsequent physical function.
  
  
  RESULTS
  Among 85 HIV-infected men surviving ≥2 years after wasting, we evaluated physical function outcomes compared with 249 HIV-infected and 338 HIV-uninfected men with no historical wasting. In multivariable regression models, HIV-infected men with prior wasting had lower grip strength and poorer physical QoL than HIV-infected men with no wasting (P ≤ 0.03), and poorer physical QoL, but higher mental QoL than HIV-uninfected men (P ≤ 0.05). When controlling for measures of immune suppression (nadir CD4 T-cell count/AIDS, the association between wasting and physical QoL was markedly attenuated, whereas there was minimal impact on the association between wasting and grip strength.
  
  
  CONCLUSIONS
  HIV-infected wasting survivors had weaker grip strength compared with HIV-infected persons without wasting; immune suppression was associated only with physical QoL. HIV-infected survivors of wasting may represent a population of adults at increased risk for physical function decline.
authors.affiliation: aUniversity of Colorado, Aurora, Colorado bJohns Hopkins University, Baltimore, Maryland cUniversity of California Los Angeles, Los Angeles, California dNorthwestern University, Chicago, Illinois eOhio State University, Columbus, Ohio, USA.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Erlandson
authors.forename: Xiuhong
authors.initials: X
authors.lastname: Li
authors.forename: Alison G
authors.initials: AG
authors.lastname: Abraham
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Margolick
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Palella
authors.forename: Susan L
authors.initials: SL
authors.lastname: Koletar
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
mesh_terms: D000328:Adult; D019247:HIV Wasting Syndrome / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies