Physical function, grip strength and frailty in people living with HIV in sub-Saharan Africa: systematic review.
To present the current knowledge on physical function, grip strength and frailty in HIV-infected patients living in sub-Saharan Africa, where the phenomenon is largely underestimated.



A systematic search was conducted on MEDLINE, Scopus and African Index Medicus. We reviewed articles on sub-Saharan African people living with HIV (PLHIV) >18 years old, published until November 2016.



Of 537 articles, 12 were conducted in six African countries and included in this review. Five articles reported information on functional limitation and one on disability. Two of these five articles reported functional limitation (low gait speed) in PLHIV. Disability was observed in 27% and 3% of PLHIV living in rural and urban places, respectively. Two of three studies reporting grip strength reported lower grip strength (nearly 4 kg) in PLHIV in comparison with uninfected patients. One study reported that PLHIV were more likely to be frail than HIV-uninfected individuals (19.4% vs. 13.3%), whereas another reported no statistical difference.



Decline in physical function, grip strength and frailty are now part of the burden of PLHIV living in SSA countries, but current data are insufficient to characterise the real public health dimension of these impairments. Further studies are needed to depict this major public health challenge. As this is likely to contribute to a significant burden on the African healthcare systems and human resources in the near future, a holistic care approach should be developed to inform guidelines.
INSERM, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.|School of Public Health (ISPED), University of Bordeaux, Bordeaux, France.
Charlotte
C
Bernard
INSERM, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.|School of Public Health (ISPED), University of Bordeaux, Bordeaux, France.
François
F
Dabis
INSERM, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France.|School of Public Health (ISPED), University of Bordeaux, Bordeaux, France.
Nathalie
N
de Rekeneire
D017954:Africa South of the Sahara; D006233:Persons with Disabilities; D005260:Female; D005684:Gait; D015658:HIV Infections / Q000150:complications*; D018737:Hand Strength; D006801:Humans; D008297:Male; D051346:Mobility Limitation

HIV
; 
VIH
; Africa; Afrique; aging; envejecimiento; fonction physique; force de préhension; fragilidad; fragilité; frailty; fuerza de prensión; función física; grip strength; physical function; vieillissement; África