The relationship of physical performance with HIV disease and mortality

被引：70

作者：

Greene, Meredith ^{[1
,2
]}

Covinsky, Kenneth ^{[1
,2
]}

Astemborski, Jacquie ^{[3
]}

Piggott, Damani A. ^{[3
,4
]}

Brown, Todd ^{[5
]}

Leng, Sean ^{[6
]}

Galai, Noya ^{[3
,7
]}

Mehta, Shruti H. ^{[3
]}

Guralnik, Jack ^{[8
]}

Patel, Kushang V. ^{[9
]}

Kirk, Gregory D. ^{[3
,4
]}

机构：

[1] Univ Calif San Francisco, Dept Med, Div Geriatr, San Francisco, CA USA

[2] San Francisco VA Med Ctr, San Francisco, CA USA

[3] Johns Hopkins Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA

[4] Johns Hopkins Univ, Sch Med, Dept Med, Div Infect Dis, Baltimore, MD 21205 USA

[5] Johns Hopkins Univ, Sch Med, Dept Med, Div Endocrinol & Metab, Baltimore, MD 21205 USA

[6] Johns Hopkins Univ, Sch Med, Dept Med, Div Geriatr & Gerontol, Baltimore, MD 21205 USA

[7] Univ Haifa, Dept Stat, Har Hakarmel, Israel

[8] Univ Maryland, Sch Med, Dept Epidemiol & Publ Hlth, Baltimore, MD 21201 USA

[9] Univ Washington, Dept Anesthesiol & Pain Med, Seattle, WA 98195 USA

来源：

AIDS | 2014年 / 28卷 / 18期

基金：

美国国家卫生研究院;

关键词：

aging; HIV; injection drug use; mortality; physical function; LOWER-EXTREMITY FUNCTION; EFFECTIVE ANTIRETROVIRAL THERAPY; INJECTION-DRUG USERS; SUBSEQUENT DISABILITY; FUNCTIONAL IMPAIRMENT; OLDER PERSONS; IL-6; LEVELS; INFECTION; FRAILTY; AGE;

D O I：

10.1097/QAD.0000000000000507

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: To evaluate whether HIV infection was associated with reduced physical performance, and to examine if reduced physical performance predicted mortality in our aging cohort of HIV-infected and HIV-uninfected persons. Design: Prospective, observational cohort of current and former injection drug users in the AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland, USA. Methods: The Short Physical Performance Battery (SPPB) was used as an objective measure of physical performance and measured semiannually along with behavioral and demographic data. Correlates of reduced physical performance (SPPB score < 10) were identified and the relationship between reduced physical performance, HIV infection and mortality was analyzed by Cox regression. Results: Among 12 270 person-visits contributed by 1627 participants, the median age was 51, 30.3% were HIV-infected and 32.6% had an SPPB score 10 or less. In multivariable models, HIV infection was independently associated with 30% increased odds of reduced physical performance [odds ratio 1.30; 95% confidence interval (CI): 1.12-1.52]. Reduced physical performance predicted mortality in a dose-response manner and within all HIV disease strata. Whereas reduced physical performance alone (hazard ratio 2.52, 95% CI: 1.59-4.00) and HIV infection alone (hazard ratio 2.78, 95% CI: 1.70-4.54) increased mortality, HIV-infected participants with reduced physical performance had a six-fold increased mortality risk (hazard ratio 6.03, 95% CI: 3.80-10.0) compared with HIV-uninfected participants with higher physical performance. Conclusion: HIV infection was independently associated with reduced physical performance. HIV and reduced physical performance have independent and joint effects on mortality. Physical performance measurement may be an important research and clinical tool to predict adverse outcomes among aging HIV-infected persons. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

引用

页码：2711 / 2719

页数：9

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