Decline in locomotor functions over time in HIV-infected patients.

Laura Richert, Mathilde Brault, Patrick Mercié, Frédéric-Antoine Dauchy, Mathias Bruyand, Carine Greib, François Dabis, Fabrice Bonnet, Geneviève Chêne, Patrick Dehail
AIDS. 2014-06-01; 28(10): 1441-1449
DOI: 10.1097/qad.0000000000000246

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1. AIDS. 2014 Jun 19;28(10):1441-9. doi: 10.1097/QAD.0000000000000246.

Decline in locomotor functions over time in HIV-infected patients.

Richert L(1), Brault M, Mercié P, Dauchy FA, Bruyand M, Greib C, Dabis F, Bonnet
F, Chêne G, Dehail P; Groupe d’Epidémiologie Clinique du SIDA en Aquitaine
(GECSA).

Collaborators: Allard M, Amieva H, Auriacombe M, Auriacombe S, Bestaven E, Bonnet
F, Brault M, Bruyand M, Catheline G, Chêne G, Coldefy G, Dabis F, Dartigues JF,
Dauchy FA, Delveaux S, Dufouil C, Dehail P, Greib C, Lewden C, Macua J, Marquant
F, Matharan F, Mercié P, Milien C, Morlat P, Raoux N, Richert L, Dabis F, Bonnet
F, Breilh D, Dabis F, Dupon M, Chêne G, Fleury H, Malvy D, Mercié P, Pellegrin I,
Morlat P, Neau D, Pellegrin JL, Bouchet S, Gaborieau V, Lacoste D, Tchamgoué S,
Thiébaut R, Bruyand M, Lawson-Ayayi S, Wittkop L, Bruyand M, Chêne G, Dabis F,
Lason-Ayayi S, Thiébaut R, Wittkop L, Morlat P, Bonnet F, Bernard N, Hessamfar M,
Lacoste D, Vandenhende MA, Dupon M, Dauchy FA, Dutronc H, Longy-Boursier M,
Mercié P, Duffau P, Schmeltz JR, Malvy D, Pistone T, Receveur MC, Neau D,
Cazanave C, Ochoa A, Vareil MO, Pellegrin JL, Viallard JF, Greib C, Lazaro E,
Fleury H, Lafon ME, Masquelier B, Trimoulet P, Breilh D, Molimard M, Bouchet S,
Titier K, Moreau JF, Pellegrin I, Haramburu F, Miremont-Salamé G, Dupont A,
Gerard Y, Caunègre L, André K, Bonnal F, Farbos S, Gemain MC, Ceccaldi J,
Tchamgoué S, De Witte S, Courtault C, Monlun E, Gaborieau V, Lataste P, Meraud
JP, Chossat I, Blaizeau MJ, Decoin M, Hannapier C, Lenaud E, Pougetoux A,
Delveaux S, D’Ivernois C, Delaune J, Leleux O, Uwamaliya-Nziyumvira B, Sicard X,
Geffard S, Bruyand M, Lawson-Ayayi S, Louis I, Palmer G, Conte V, Touchard D,
Leray J, Frosch A, Bruyand M, Chêne G, Dabis F, Lawson-Ayayi S, Fleury H, Moreau
JF, Breilh D, Dupon M, Lacoste D, Mercié P, Morlat P, Neau D, Pellegrin JL.

Author information:
(1)aINSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique & CIC-EC7
bUniversity Bordeaux cCentre Hospitalier Universitaire (CHU) de Bordeaux dEA
4136, University Bordeaux, Bordeaux, France.

Comment in
AIDS. 2014 Jun 19;28(10):1531-2.

OBJECTIVES: To assess changes in locomotor function in HIV-infected patients and
to evaluate the determinants of variations in lower limb muscle performance.
DESIGN: Longitudinal study within the ANRS CO3 Aquitaine Cohort.
METHODS: Standardized locomotor tests, including global functional capacity
[6-min walk distance (6MWD)] and lower limb muscle performance tests [five times
sit-to-stand (5STS) test], were performed in HIV-infected adults at baseline and
2-year follow-up. Evolution of performances and determinants of 5STS time were
studied in linear mixed-effects models.
RESULTS: At baseline (354 patients, 90% on antiretroviral treatment), median 5STS
time was 9.8 s and 6MWD 549 m. Poorer performances were associated with falls,
reported by 12% of 178 patients at follow-up. Estimated mean deterioration was
+0.24 s/year (P < 10) for 5STS time and -11 m/year (P < 10) for 6MWD. In
multivariable analyses, older age was associated with worse baseline 5STS time
(+0.47 s/10-year age increase; P = 10), but not with further deterioration.
Deterioration was greater in prior injecting drug users compared to others
(difference in slope +0.62 s/year; P = 0.04). 5STS time at any time point was
worse in patients with history of cerebral AIDS conditions (+2.47 s; P < 10) and
diabetes (+0.95 s; P = 0.02) than in others. No significant associations were
found for antiretroviral treatment type, viral load or CD4 cell count.
CONCLUSION: Compared to published data from healthy persons of similar age,
baseline 5STS time and 6MWD were poorer in HIV-infected adults and associated
with subsequent falls. Test performances deteriorated further over time. Age,
diabetes, neurologic complications and injection drug use, rather than virologic
factors, contribute to variations in lower limb muscle performance.

DOI: 10.1097/QAD.0000000000000246
PMID: 24566096 [Indexed for MEDLINE]

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