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Physical Function Impairment on Quality of
Life among Persons Aging with HIV Infection
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......level of physical function affects quality of life....at baseline the HIV+ participants in this study had quality of life lower than general population, but after an exercise routine provided through this study exercise capacity improved which was correlated with improved physical functioning due to the exercise & which all correlated with improved quality of life....in a previous study discussed just below this author Erlandson found inflammation & immune activation which are associated with frailty to be associated with functional impairment/physical functioning capacity that is limited physical activity, in this study participants underwent exercise tests to evaluate their level of physical functioning
Reported by Jules Levin
CROI 2014 March 3-6 Boston, MA
KM Erlandson, AA Allshouse, CM Jankowski, S MaWhinney, WM Kohrt, TB Campbell University of Colorado. Aurora, CO
From Jules:
In a previous study Erlandson found higher inflammation associated with physical impairment (not exercising, being sedentary):
"Association of Functional Impairment with Inflammation and Immune Activation in HIV Type 1-Infected Adults Receiving Effective Antiretroviral Therapy".........
http://www.natap.org/2014/HIV/030314_01.htm
"functional impairment during HIV infection is associated with markers of immune activation and inflammation.......Aging with HIV infection is associated with early decline in physical function and development of frailty......this is the first evidence linking physical function and frailty to immune activation and inflammation among persons with HIV infection......Functional impairment during successful antiretroviral therapy was associated with higher CD8+ T-cell activation and interleukin 6 levels. Interventions to decrease immune activation and inflammation should be evaluated for their effects on physical function and frailty.
.......Low-function cases had a lower nadir CD4+ T-cell count, a greater number of comorbid conditions.....Similar to prior studies of frailty and disability among HIV-uninfected elderly individuals, we detected an association between high IL-6 level and low functional status and a trend toward higher hs-CRP and TNF-α levels, suggesting an overall inflammatory milieu among functionally impaired persons......Moreover, increased CD8+ T-cell activation was also associated with functional impairment among HIV-infected persons. Higher IL-6 level is closely linked to frailty, disability, and mortality among HIV-uninfected elderly individuals"
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This is an exercise study " Cross-sectional study of participants age 45-65 years, on ART for ≥ 6 months with HIV-1 RNA <48 copies". in 359 participants with average age of 51 (48-56), avg CD4 551, 5% were not undetectable with viral load.
Participants "Completed physical activity & quality of life (SF-36) questionnaires (quality of life) physical function assessment (400-m walk, 5-time chair rise test, and grip strength. Veterans Aging Cohort Study (VACS) index scores were calculated as previously described"
"Analyses: SF-36 scores were normalized to a population mean of 50 points"
At baseline HIV+ had lower scores than the population mean for bodily pain, general health, vitality & social functioning.
The study reports that increased exercising improved the SF36, quality of life, both better physical & mental health quality of life (see Summary below), and the authors suggest:
Targeted exercise programs to increase physical activity and improve speed (400-m walk) and power (chair rise) should be evaluated as interventions to improve quality of life during ART"
Of note, look below to graph of Physical Activity (Kcal/week), you will see the measure as high as 20,000 calories burnt per week by some study participants, and there is a straight line up in this graph showing a direct correlation wth the more calories one burnt in this study the greater the improvement in physical health, to me this is very important showing more exercise improves physical health evaluation by the quality of health test SF36.
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