Kulik Grace L, Umbleja Triin, Brown Todd T, Ribaudo Heather J, Grinspoon Steven K, Schrack Jennifer A, Zanni Markella V, Diggs Marissa R, Aberg Judith A, Fichtenbaum Carl J, Malvestutto Carlos D, Chu Sarah M, Currier Judith S, Douglas Pamela S, Bloomfield Gerald S, Thornton Alice C, Floris-Moore Michelle A, Goodenough Elliot, Ellsworth Grant B, Burdo Tricia, Erlandson Kristine M
University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
Open Forum Infect Dis. 2025 May 27;12(6):ofaf311. doi: 10.1093/ofid/ofaf311. eCollection 2025 Jun.
Pitavastatin to REduce Physical Function Impairment and FRailty in HIV (PREPARE) found small declines in physical function overall among people with HIV (PWH). However, there was substantial individual variability. The purpose of this prespecified exploratory analysis was to identify the PWH at greatest risk for physical function decline.
Participant-specific annualized rates of change on annually measured chair rise rate, gait speed, the modified Short Performance Physical Battery (composite of the latter 2 plus balance time), and grip strength were estimated from linear mixed-effect models. Change in performance that was below the 20th percentile of the study population in ≥1 measure was classified as physical function decline. Associations between baseline factors and physical function decline were evaluated with log-binomial regression models.
Of 569 participants (81% male, 52% White), the median age (Q1-Q3) was 51 (47-55) years. Half (52%) of the participants had decline in physical function. The risk of decline was higher among females (relative risk [RR], 1.32; 95% CI, 1.12-1.55) and non-Whites (RR, 1.23; 95% CI, 1.05-1.45) and tended to increase with age (50-55 years: RR, 1.04; 95% CI, 0.86-1.26; 55+ vs 40-<50 years: RR, 1.17; 95% CI, 0.98-1.39). In models adjusted for age, sex, and race, we found greater risk of decline among those with history of depression treatment, higher body mass index (BMI), preexisting functional impairment, frailty (by index), and higher baseline high-sensitivity C-reactive protein and interleukin-6 levels.
PWH with history of depression treatment, high BMI, or levels of inflammation and those showing early signs of functional impairment may be at higher risk of physical function decline and should be targeted for early interventions to preserve physical function with aging.
匹伐他汀减少HIV感染者身体功能损害和虚弱（PREPARE）研究发现，HIV感染者（PWH）的身体功能总体上有小幅下降。然而，个体差异很大。这项预先设定的探索性分析的目的是确定身体功能下降风险最高的PWH。
通过线性混合效应模型估计参与者每年测量的椅子起立速度、步速、改良简短体能测试（后两者与平衡时间的综合指标）和握力的个体特定年化变化率。在≥1项测量中，表现变化低于研究人群第20百分位数被归类为身体功能下降。使用对数二项回归模型评估基线因素与身体功能下降之间的关联。
569名参与者（81%为男性，52%为白人），年龄中位数（Q1-Q3）为51（47-55）岁。一半（52%）的参与者身体功能下降。女性（相对风险[RR]，1.32；95%CI，1.12-1.55）和非白人（RR，1.23；95%CI，1.05-1.45）下降风险更高，并随年龄增加而增加（50-55岁：RR，1.04；95%CI，0.86-1.26；55岁及以上与40-<50岁相比：RR，1.17；95%CI，0.98-1.39）。在调整年龄、性别和种族的模型中，我们发现有抑郁症治疗史、较高体重指数（BMI）、既往功能损害、虚弱（通过指数衡量）以及较高基线高敏C反应蛋白和白细胞介素-6水平的参与者下降风险更大。
有抑郁症治疗史、高BMI或炎症水平以及有功能损害早期迹象的PWH身体功能下降风险可能更高，应针对其进行早期干预，以在衰老过程中保持身体功能。
