Centre Population and Development (Ceped), French National Research Institute for Sustainable Development (IRD) and Paris University, Inserm ERL 1244, 45 Rue Des Saints Pères, 75006, Paris, France.
Infectious and Tropical Diseases Service (SMIT), Treichville Teaching Hospital, Abidjan, Côte d'Ivoire.
BMC Public Health. 2024 Jun 8;24(1):1549. doi: 10.1186/s12889-024-19020-9.
People living with HIV (PLWH) live longer and face new health challenges resulting from the confluence of chronic HIV infection and the natural effect of aging and comorbidities. However, there is a dearth of information on the long-term impact of HIV infection on the health and wellbeing of PLWH in sub-Saharan Africa. This research aimed to fill this gap by reporting on physical, functional and social outcomes among PLWH treated at a referral center in Abidjan, Ivory Coast, and comparing them with those of a control group.
Body composition, functional capacity, sarcopenia, limitations in daily activities and social participation were assessed among 300 PLWH (aged ≥ 30 years) and 200 uninfected adults of similar age and sex. The associations between these outcomes and participants' socioeconomic characteristics, HIV history and physical activity level were assessed using generalized additive models adjusted for age and sex.
The median age was 51 years, and the median antiretroviral therapy duration was 15 years. Compared to controls, PLWH reported higher levels of physical activity (p < 0.0001). They had a lower muscle index (adjusted p < 0.0001) and grip strength (adjusted p < 0.0001) but achieved similar performance on the 6-min walk test (6MWT, p = 0.2). Among PLWH, physical activity level was positively associated with better performance in the 6MWT (p = 0.006) and greater hand grip strength (p = 0.04). The difference in physical performance according to the level of physical activity appeared mainly after the age of 60. PLWH reported similar rates of activity limitations (p = 0.8), lower depression levels and greater scores for social functioning (p = 0.02).
In this study, PLWH achieved high levels of physical activity, which may explain why they maintained good physical performance and social functioning despite having a higher risk of sarcopenia. These results have important implications for resource-limited health systems and show avenues for chronic care models.
This study was registered on the ClinicalTrials.gov website (NCT05199831, first registration the 20/01/2022).
HIV 感染者（PLWH）寿命延长，面临着慢性 HIV 感染与衰老和合并症自然效应共同作用带来的新健康挑战。然而，在撒哈拉以南非洲，有关 HIV 感染对 PLWH 健康和幸福感的长期影响的信息仍然匮乏。本研究旨在填补这一空白，报告科特迪瓦阿比让的一个转诊中心治疗的 PLWH 的身体、功能和社会结局，并将其与对照组进行比较。
评估了 300 名 PLWH（年龄≥30 岁）和 200 名年龄和性别相似的未感染成年人的身体成分、功能能力、肌肉减少症、日常活动限制和社会参与情况。使用广义加性模型评估这些结局与参与者的社会经济特征、HIV 病史和身体活动水平之间的关联，并根据年龄和性别进行调整。
中位年龄为 51 岁，中位抗逆转录病毒治疗时间为 15 年。与对照组相比，PLWH 的身体活动水平更高（p<0.0001）。他们的肌肉指数较低（调整后 p<0.0001）和握力较低（调整后 p<0.0001），但 6 分钟步行试验（6MWT）的表现相似（p=0.2）。在 PLWH 中，身体活动水平与 6MWT 表现更好（p=0.006）和握力更大（p=0.04）呈正相关。根据身体活动水平的身体表现差异主要出现在 60 岁以后。PLWH 报告的活动受限率相似（p=0.8），抑郁程度较低，社会功能评分较高（p=0.02）。
在这项研究中，PLWH 达到了较高的身体活动水平，这可能解释了为什么他们尽管肌肉减少症风险较高，但仍能保持良好的身体表现和社会功能。这些结果对资源有限的卫生系统具有重要意义，并为慢性病管理模式提供了途径。
本研究在 ClinicalTrials.gov 网站注册（NCT05199831，首次注册日期为 2022 年 1 月 20 日）。
