Oursler K K, Sorkin J D, Smith B A, Katzel L I
University of Maryland School of Medicine, and the Baltimore Veterans Administration Medical Center, Geriatric Research, Education and Clinical Center, Baltimore, Maryland 21201, USA.
AIDS Res Hum Retroviruses. 2006 Nov;22(11):1113-21. doi: 10.1089/aid.2006.22.1113.
Aerobic capacity and physical functioning decline with age and chronic illness. The extent of physical disability is unknown in older HIV-infected adults, who represent a rapidly growing proportion of HIV/AIDS patients in the United States. We performed functional performance testing including treadmill testing in 32 HIV-infected male veterans aged 40-69 years. Controls were 47 healthy male subjects tested previously in the same exercise laboratory. HIV-infected subjects were classified as younger (40-49 years, n = 12) or older age (50+ years, n = 20). Peak aerobic capacity (VO2peak) was significantly reduced in the older vs. younger HIV subjects [19.1 mL/kg/min +/- 5.7 (mean, SD) vs. 25.2 +/- 4.2, p = 0.01]. VO2peak was reduced 41% +/- 15% (mean, SD) in HIV-infected subjects compared to expected values from age-matched healthy controls. Regression analyses show a similar decline in VO2peak with age in HIV-infected and healthy controls. Mean 6-min walk distance was not significantly different between the HIV-infected age groups, and was reduced only 8% compared to expected values for healthy adults. Current CD4 count and HAART exposure were similar in the two age groups and were not significantly associated with VO2peak. Anemia (HCT <35%) was significantly associated with reduced VO2peak (p = 0.02), but this association was not independent of the effect of age (p = 0.1). We conclude that older HIV-infected adults have markedly impaired aerobic capacity but maintain the capacity to undertake day-to-day activities. Additional physiologic and metabolic testing is needed to measure the effect of HAART toxicity and primary aging on aerobic capacity, and to determine if older HIV-infected adults are at greater risk.
有氧能力和身体机能会随着年龄增长和慢性病而下降。在美国，老年HIV感染成人在HIV/AIDS患者中所占比例迅速增加，但其身体残疾程度尚不清楚。我们对32名年龄在40 - 69岁的HIV感染男性退伍军人进行了功能表现测试，包括跑步机测试。对照组为47名之前在同一运动实验室接受测试的健康男性受试者。HIV感染受试者分为较年轻组（40 - 49岁，n = 12）和较年长组（50岁及以上，n = 20）。与较年轻的HIV受试者相比，较年长的HIV受试者的峰值有氧能力（VO2peak）显著降低[19.1毫升/千克/分钟±5.7（均值，标准差）对25.2±4.2，p = 0.01]。与年龄匹配的健康对照组的预期值相比，HIV感染受试者的VO2peak降低了41%±15%（均值，标准差）。回归分析表明，HIV感染组和健康对照组的VO2peak随年龄下降情况相似。HIV感染的两个年龄组之间的平均6分钟步行距离无显著差异，与健康成年人的预期值相比仅降低了8%。两个年龄组的当前CD4细胞计数和抗逆转录病毒治疗暴露情况相似，且与VO2peak无显著关联。贫血（血细胞比容<35%）与VO2peak降低显著相关（p = 0.02），但这种关联并非独立于年龄的影响（p = 0.1）。我们得出结论，老年HIV感染成人的有氧能力明显受损，但仍保持进行日常活动的能力。需要进行额外的生理和代谢测试，以评估抗逆转录病毒治疗毒性和自然衰老对有氧能力的影响，并确定老年HIV感染成人是否面临更大风险。
