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Gouvêa-E-Silva LF, Brito ERD, Sol NCC, Fernandes EV, Xavier MB. Relationship of handgrip strength with health indicators of people living with HIV in west Pará, Brazil. Int J STD AIDS 2023; 34:932-939. [PMID: 37436258 DOI: 10.1177/09564624231188749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND Handgrip strength (HGS) is an important health indicator that can be influenced by body composition and biochemical markers of people living with HIV, contributing to better understanding of health-related outcomes. OBJECTIVE To analyze the relationship between HGS and health indicators in people living with HIV. METHODS Cross-sectional study, with 207 people living with HIV, attending a reference center, located in Santarém, Pará, Brazil. Data collection covered sociodemographic, clinical, laboratory, physical activity level, body composition, and HGS information. Data were analyzed using descriptive and inferential statistics, adopting p < .05. RESULTS There was a predominance of men (60%), aged 33-47 years (42%). A relationship was observed between adequate HGS and the male sex (p < .001), and adequate values for body mass index (p = .003), abdominal circumference (p < .001), and total cholesterol (p = .012). In addition, higher values of fat mass (p < .001), and lower lean mass (p = .006) were observed for people living with HIV with low HGS. CONCLUSION People living with HIV present an association between lean body mass and high HGS. On the other hand, low HGS favored obesity and hypercholesterolemia. Thus, monitoring HGS is an important indicator of body, laboratory, and functional capacity changes, with HGS being an additional element in the clinical evaluation.
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Affiliation(s)
- Luiz Fernando Gouvêa-E-Silva
- Instituto de Biociências, Universidade Federal de Jataí, Jataí, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | | | | | | | - Marília Brasil Xavier
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
- Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará, Belém, Brazil
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Inflammatory and Cardiovascular Correlates of Physical Activity and Sedentary Behavior in Older Adults Living With HIV. J Phys Act Health 2023; 20:149-156. [PMID: 36640774 DOI: 10.1123/jpah.2022-0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/07/2022] [Accepted: 11/11/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Inflammation is an indicator of oxidative stress that may contribute to cardiovascular diseases in older people living with HIV (OPWH). Physical activity (PA) may reduce these biomarkers in OPWH, but little is known about the association of PA with inflammatory and cardiovascular biomarkers. We sought to examine the inflammatory and cardiovascular biomarker correlates of PA and sedentary behavior in OPWH. METHODS We included 101 OPWH with complete assessments of PA, sedentary behavior, and biomarker data to examine the association between the volume of PA and inflammatory and cardiovascular biomarkers. RESULTS In this cohort of OPWH (mean age 55.9 y), 68% were male and 83% were African American/Black. Among OPWH, greater volume of PA (ie, walking, moderate, vigorous, and/or total) was associated with lower systolic (P < .05) and diastolic blood pressure (P < .05), pulse pressure (P < .05), and tumor necrosis factor-alpha (P < .05). Greater duration of sitting was associated with greater triglycerides, interleukin-6, and tumor necrosis factor-alpha (P < .05). CONCLUSIONS Although adherence to regular PA among OPWH is low and sedentary behavior is high, the associations between biomarkers and PA suggest a greater volume of PA could attenuate the inflammatory and cardiovascular derangements experienced by OPWH.
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HIV infection in the west region of Pará. SCIENTIA MEDICA 2021. [DOI: 10.15448/1980-6108.2021.1.38938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims: knowledge of the patient’s profile, for the evaluation and suggested behaviors, promotes a favorable outcome. Thus, the objective of the study is to analyze the socioeconomic, clinical, and immunological characteristics of patients infected by the human immunodeficiency virus in the western region of the state of Pará.Methods: were analyzed 1966 medical records of patients whose first visit to a reference center, in the municipality of Santarém-PA, was between 1998 and 2018. Socioeconomic, clinical, and immunological information was collected from patient medical records. Data were analyzed using descriptive and inferential statistics, adopting p <0.05.Results: there was a predominance of males (62.5%), aged 20-39 years (69.1%), elementary school (58.6%), single (57.3%), and employed (66.4%). Immunosuppression was present in 22% of patients and a viral load was detectable in 66%. Tuberculosis (37%) and toxoplasmosis (23%) predominated as opportunistic infections, and syphilis (62.6%) and human papillomavirus (HPV; 14%) as other infections.Conclusions: it is concluded that both opportunistic infections and other infections were present in 25-22% of the patients and that the presence of opportunistic infections favors the installation of another infection, or vice versa. Toxoplasmosis, HPV, and syphilis are positively associated with men, and toxoplasmosis and tuberculosis with age >35 years. Immunosuppression was shown to be positively associated with men and age >35 years, as well as favoring the onset of tuberculosis, toxoplasmosis, and detectable viral load.
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Ferrari Silva B, Barletta F, Pedro RE, Batista ML, Hernandes L, Franzói de Moraes SM, Barnabé Peres S. Concurrent training remodels the subcutaneous adipose tissue extracellular matrix of people living with HIV: a non-randomized clinical trial. Appl Physiol Nutr Metab 2021; 46:1476-1486. [PMID: 34293264 DOI: 10.1139/apnm-2021-0284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Evaluate the effect of 12wks of concurrent training (CT) in extracellular matrix (ECM) of subcutaneous adipose tissue (SAT) in people living with HIV/aids (PLWHA). To the non-randomized clinical trial 19 participants, 11 healthy (HIV-) and 18 PLWHA under the use of highly active antiretroviral therapy (HAART) for at least 1 year (HIV+). All participants engaged in a moderate-intensity CT program for 12 weeks, three times a week. Before and after CT, aerobic and strength performance were assessed, as well as anthropometry and biochemical blood profile. Also, SAT biopsies were carried out for histologic and morphometric analysis. The statistical analysis was carried out with R Studio, using descriptive and inferential analysis, ANOVA test and mixed-effect model were utilized (P<0.05). HIV+ showed higher levels of VLDL, TGL, and lower levels of HDL in baseline than HIV- (P<0.05). All groups improved aerobic and strength performance (P<0.05). Both groups presented reduced adipocyte sizes after CT (P<0,05). Lastly, HIV+ presented smaller adipocytes and higher elastic fiber deposition in baseline and decreased after training only in HIV+, matching similarly to HIV- group. Thus, CT in PLWHA promoted a decrease in size heterogeneity of adipocytes and elastic fiber deposition, remodeling ECM and improving SAT fibrosis profile. Brazilian Clinical Trials Registry (UTN: U1111-1214-3022) Novelty • Adipose tissue fibrosis is improved by training in people living with HIV. • Concurrent training remodels adipose tissue extracellular matrix.
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Affiliation(s)
- Bruno Ferrari Silva
- State University of Maringá Maringá, Department of Physiological Sciences, Paraná, Brazil;
| | - F Barletta
- State University of Maringá Maringá, Department of Biostatistics, Paraná, Brazil;
| | - R E Pedro
- State University of Londrina, 37894, Department of Physical Education, Londrina, Paraná, Brazil;
| | - Miguel L Batista
- University of Mogi das Cruzes, 133647, Department of Integrated Biotechnology, Mogi das Cruzes, Brazil;
| | - L Hernandes
- State University of Maringá Maringá, Department of Morphological Sciences, Paraná, Brazil;
| | | | - Sidney Barnabé Peres
- Universidade Estadual de Maringa, 42487, Physiological Sciences, Maringa, PR, Brazil;
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Chisati EM, Munthali F, Constantinou D, Lampiao F. Physical activity levels among Malawian adults living with HIV and receiving anti-retroviral therapy. Malawi Med J 2020; 32:8-12. [PMID: 32733653 PMCID: PMC7366159 DOI: 10.4314/mmj.v32i1.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Despite increasing life expectancy among people living with HIV (PLWHIV), anti-retroviral therapy (ART) side effects, HIV chronic inflammation and co-morbidities may limit functional abilities and reduced participation in exercises and physical activity (PA). PA improves wellbeing and overall quality of life of PLWHIV. In Malawi, there is paucity of information regarding PA levels among Malawians living with HIV and receiving ART. Therefore, this study aimed at determining PA levels among PLWHIV and receiving ART in Malawi. Methods A quantitative cross-sectional design was employed. Eligible participants were male and female adults aged 18–45 years living with HIV receiving ART for at least 1 year. The participants were recruited from Limbe Health Center, Gateway Health Center and Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. The International Physical Activity Questionnaire (IPAQ) was used to assess the PA levels. A Stadiometer (HS-DBS00361, Model: 1127154) was used to measure weight (kg) and height (cm) of the participants. Results A total of 213 participants were recruited. There were more females than male participants (n=132 females). Overall, the mean age of all participants was 37±6.5 years and they were within normal body weight (BMI=23±4.0). Many participants (n=85, 40%) had low PA levels followed by those who were moderately physically active (n=75, 36%). A larger proportion of the female participants (51%) had low PA levels compared to males (22%). Forty-two percent of participants with 1–3 years of ART had low PA whereas 39% with >3 years ART had low PA. Conclusion Most PLWHIV and receiving ART in the sample have low PA levels. The study has also revealed that proportionally more females than males had low PA levels.
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Affiliation(s)
- Enock M Chisati
- Department of Physiotherapy, College of Medicine, University of Malawi, Blantyre, Malawi.,Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya
| | | | - Demitri Constantinou
- Center for Exercise Science and Sports Medicine, FIMS Collaborating Center of Sports Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Fanuel Lampiao
- Department of Biomedical Sciences, College of Medicine, University of Malawi, Blantyre, Malawi.,Africa Centre of Excellence in Public Health and Herbal Medicine (ACEPHEM)
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Ghayomzadeh M, Etesami MS, Earnest CP, Rezaei S, Navalta JW, Taj L, SeyedAlinaghi S, Mohraz M, Gharakhanlou R, Voltarelli FA. Effect of a Short-term Lifestyle Modification Program on Quality of Life, Anthropometric Characteristics and CD4+T Cell Count of HIV Infected Patients in Tehran/Iran: A Randomized Controlled Trial. Explore (NY) 2019; 15:308-315. [PMID: 30833130 DOI: 10.1016/j.explore.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/18/2019] [Accepted: 01/31/2019] [Indexed: 02/08/2023]
Abstract
CONTEXT Increasing physical activity and promoting healthy behaviors may play a key role in reducing the adverse effects of antiretroviral therapy and HIV. OBJECTIVE This study investigated the effects of an 8-week lifestyle modification program (LMP) on quality of life, anthropometric characteristics and CD4+T cell count of people living with HIV (PLWH). METHODS Thirty PLWH taking ART were randomly assigned to a lifestyle modification program (LMP) (n = 15) or standard care control (CON) group (n = 15). All volunteers underwent body composition, CD4+T cell count measurement and quality of life assessments at the beginning and end of a two-month experimental period. RESULTS At follow-up, we observed a significant increase in CD4+T cell count (117.52 cells/mm3; 95% CI, 36.59-198.45) and all subscales and total quality of life score (Short-Form 36 (SF-36) in the LMP group. While we did not observe a significant change in body composition for the LMP group, we did observe a significant increase in body fat (1.75%; 95% CI, 0.15, 2.33) and a reduction in lean body mass (-1.26; 95% CI, -1.26, -2.39) for the CON group. CONCLUSION A LMP can be safely used as an effective intervention for improving quality of life and immune competence of PLWH who lack time to participate in a structured exercise regimen. TRIAL REGISTRATION IRCT 201604034076N18. Registered: 2016-05-05 .web address of TRIAL: en.search.irct.ir/trial/4262.
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Affiliation(s)
- Morteza Ghayomzadeh
- Department of Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | | | - Conrad P Earnest
- Exercise and Sport Nutrition Laboratory, Texas A&M University, College Station, TX, USA
| | - Sajjad Rezaei
- Department of Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - James Wilfred Navalta
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
| | - Leila Taj
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Gharakhanlou
- Department of Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
| | - Fabrício Azevedo Voltarelli
- Graduation Program of Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Brazil
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Silva LLG, Santos EMD, Nascimento LCPD, Cavalcanti MCDF, Arruda IKGD, Luz MCL, Cabral PC. Lipodystrophic syndrome of HIV and associated factors: a study in a university hospital. CIENCIA & SAUDE COLETIVA 2018; 25:989-998. [PMID: 32159668 DOI: 10.1590/1413-81232020253.11772018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/05/2018] [Indexed: 11/22/2022] Open
Abstract
The use of antiretroviral drugs has increased the survival of HIV patients, but may have side effects, such as lipodystrophic syndrome. This article aims to identify the frequency of the lipodystrophic syndrome and its associated factors in patients with HIV using antiretroviral therapy. It involved a cross-sectional study with HIV patients, monitored on an outpatient basis. The syndrome was evaluated by the association of two parameters: peripheral weight loss through the lipodystrophy severity scale and central fat accumulation, measured by the hip waist ratio. Poisson regression analysis was performed to identify the associated variables. Of the 104 patients evaluated, 27.9% presented the syndrome. After adjustment, the female sex (PRadjusted = 2.16 CI95% 1.43-3.39), being overweight (PRadjusted = 2.23 CI95% 1.35-2.65) and a longer period of use of antiretrovirals (PRadjusted = 1.64 CI95% 1.16-2.78), remained positively associated with the syndrome. On the other hand, a negative association with CD4 count £ 350 (PRadjusted = 0.39 CI95% 0.10-0.97) was observed The high prevalence of the syndrome and its association with specific groups reinforce the need for adequate follow-up and early identification to intervene in modifiable factors.
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Affiliation(s)
- Lídia Laís Gomes Silva
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
| | - Eryka Maria Dos Santos
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
| | - Luciana Caroline Paulino do Nascimento
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
| | - Mikaella Carla de França Cavalcanti
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
| | - Ilma Kruze Grande de Arruda
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
| | - Marcella Campos Lima Luz
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
| | - Poliana Coelho Cabral
- Programa de Residência em Nutrição Clínica, Hospital das Clínicas, Universidade Federal de Pernambuco. Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901, Recife, PE, Brasil.
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Dang AK, Nguyen LH, Nguyen AQ, Tran BX, Tran TT, Latkin CA, Zhang MWB, Ho RCM. Physical activity among HIV-positive patients receiving antiretroviral therapy in Hanoi and Nam Dinh, Vietnam: a cross-sectional study. BMJ Open 2018; 8:e020688. [PMID: 29748343 PMCID: PMC5950700 DOI: 10.1136/bmjopen-2017-020688] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Antiretroviral therapy (ART) has facilitated the transition of HIV infection into a chronic disease, where adherence to medications is required along with keeping a healthy lifestyle. Therefore, an increase in physical activity has been recommended for patients with HIV in order to maintain their health status. This study looked to determine the physical activity level and its associated factors among patients with HIV receiving ART treatment. SETTINGS Eight outpatient clinic sites across different levels of the health systems in both rural and urban settings in Hanoi and Nam Dinh, Vietnam. STUDY DESIGN AND PARTICIPANTS A cross-sectional study was performed among 1133 patients with HIV receiving ART treatment from January to August 2013. PRIMARY AND SECONDARY OUTCOME MEASURES Physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). Socioeconomic, health-related quality of life, ART adherence and ART-related characteristics were self-reported. RESULTS 16% of participants were inactive, and 68% were reported active via health-enhancing physical activity. Rural participants reported a higher level of physical activity compared with urban participants. Participants having a longer duration of ART were less likely to be physically active. Participants who were female and self-employed, who had higher CD4 cell count, higherEuroQol - 5 dimensions - 5levels (EQ-5D-5L) index/EQ-Visual Analogue Scale, and shared their health status with their peers were more likely to have a higher IPAQ score or be physically active. A lower IPAQ score was associated with participants living in urban areas and being at the symptomatic stage. Participants having poor adherence and longer duration of ART were more likely to be physically inactive. CONCLUSION The majority of participants who received ART were physically active. There is a need for interventions to promote physical activity among patients with HIV in urban areas and in the later ART treatment phases. Other potential interventions to increase the level of physical activity include peer support and job guidance.
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Affiliation(s)
- Anh Kim Dang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Anh Quynh Nguyen
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Melvyn W B Zhang
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Silveira EA, Santos ASEADC, Falco MDO, Cardoso RDC, Vitorino PVDO. Association of physical inactivity with hypertension and low educational level in people living with HIV / AIDS. AIDS Care 2018; 30:1004-1009. [PMID: 29471672 DOI: 10.1080/09540121.2018.1441968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to determine the prevalence of physical inactivity and whether it is associated with sociodemographic, lifestyle, clinical, anthropometric, and body composition variables in people living with HIV/AIDS (PLWHA). This study makes use of data from a cohort of 288 adults aged ≥19 years, conducted between October 2009 and July 2011. The variables studied were sex, age, education, income, skin color, tobacco use, alcohol intake, body mass index, body fat percentage, waist circumference, and waist-hip ratio, length of HIV/AIDS diagnosis, use of antiretroviral therapy and length of its use, CD4, hypertension (HT) and diabetes mellitus. Physical inactivity was defined as a score below 600 metabolic equivalent minutes/week according to the International Physical Activity Questionnaire - Short Version. Poisson multiple regression was applied in the multivariate analysis with a significance level of 5%. The prevalence of physical inactivity was 44.1%. Education of ≤4 years of study (prevalence ratio [PR]: 1.71) and HT (PR: 1.49) were associated with physical inactivity. Physical inactivity was highly prevalent in PLWHA and associated with low educational level and HT. We highlight the simultaneous association between two cardiometabolic risk factors, HT and physical inactivity.
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Affiliation(s)
- Erika Aparecida Silveira
- a Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina , Universidade Federal de Goiás (UFG) , Goiania , Brazil
| | | | - Marianne de Oliveira Falco
- a Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina , Universidade Federal de Goiás (UFG) , Goiania , Brazil
| | - Rodrigo de Castro Cardoso
- a Programa de Pós-graduação em Ciências da Saúde, Faculdade de Medicina , Universidade Federal de Goiás (UFG) , Goiania , Brazil
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Noorhasan M, Drozd DR, Grunfeld C, Merrill JO, Burkholder GA, Mugavero MJ, Willig JH, Willig AL, Cropsey KL, Mayer KH, Blashill A, Mimiaga M, McCaul ME, Hutton H, Chander G, Mathews WC, Napravnik S, Eron JJ, Christopoulos K, Fredericksen RJ, Nance RM, Delaney JC, Crane PK, Saag MS, Kitahata MM, Crane HM, on behalf of the Centers For AIDS R. Associations Between At-Risk Alcohol Use, Substance Use, and Smoking with Lipohypertrophy and Lipoatrophy Among Patients Living with HIV. AIDS Res Hum Retroviruses 2017; 33:534-545. [PMID: 28092168 DOI: 10.1089/aid.2015.0357] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine associations between lipohypertrophy and lipoatrophy and illicit drug use, smoking, and at-risk alcohol use among a large diverse cohort of persons living with HIV (PLWH) in clinical care. METHODS 7,931 PLWH at six sites across the United States completed 21,279 clinical assessments, including lipohypertrophy and lipoatrophy, drug/alcohol use, physical activity level, and smoking. Lipohypertrophy and lipoatrophy were measured using the FRAM body morphology instrument and associations were assessed with generalized estimating equations. RESULTS Lipohypertrophy (33% mild, 4% moderate-to-severe) and lipoatrophy (20% mild, 3% moderate-to-severe) were common. Older age, male sex, and higher current CD4 count were associated with more severe lipohypertrophy (p values <.001-.03). Prior methamphetamine or marijuana use, and prior and current cocaine use, were associated with more severe lipohypertrophy (p values <.001-.009). Older age, detectable viral load, and low current CD4 cell counts were associated with more severe lipoatrophy (p values <.001-.003). In addition, current smoking and marijuana and opiate use were associated with more severe lipoatrophy (p values <.001-.03). Patients with very low physical activity levels had more severe lipohypertrophy and also more severe lipoatrophy than those with all other activity levels (p values <.001). For example, the lipohypertrophy score of those reporting high levels of physical activity was on average 1.6 points lower than those reporting very low levels of physical activity (-1.6, 95% CI: -1.8 to -1.4, p < .001). CONCLUSIONS We found a high prevalence of lipohypertrophy and lipoatrophy among a nationally distributed cohort of PLWH. While low levels of physical activity were associated with both lipohypertrophy and lipoatrophy, associations with substance use and other clinical characteristics differed between lipohypertrophy and lipoatrophy. These results support the conclusion that lipohypertrophy and lipoatrophy are distinct, and highlight differential associations with specific illicit drug use.
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Affiliation(s)
| | - Daniel R. Drozd
- Department of Medicine, University of Washington, Seattle, Washington
| | - Carl Grunfeld
- Department of Medicine, University of California at San Francisco, San Francisco, California
| | - Joseph O. Merrill
- Department of Medicine, University of Washington, Seattle, Washington
| | - Greer A. Burkholder
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael J. Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - James H. Willig
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Amanda L. Willig
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Karen L. Cropsey
- Department of Psychiatry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kenneth H. Mayer
- Department of Medicine, Fenway Institute, Harvard Medical School, Boston, Massachusetts
| | - Aaron Blashill
- Department of Medicine, Fenway Institute, Harvard Medical School, Boston, Massachusetts
| | - Matthew Mimiaga
- Division of Psychiatry, Fenway Institute, Harvard Medical School, Boston, Massachusetts
| | - Mary E. McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | - Heidi Hutton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland
| | | | - William C. Mathews
- Department of Medicine, University of California San Diego, San Diego, California
| | - Sonia Napravnik
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Joseph J. Eron
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Katerina Christopoulos
- Department of Medicine, University of California at San Francisco, San Francisco, California
| | | | - Robin M. Nance
- Department of Medicine, University of Washington, Seattle, Washington
| | | | - Paul K. Crane
- Department of Medicine, University of Washington, Seattle, Washington
| | - Michael S. Saag
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Mari M. Kitahata
- Department of Medicine, University of Washington, Seattle, Washington
| | - Heidi M. Crane
- Department of Medicine, University of Washington, Seattle, Washington
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Vancampfort D, Mugisha J, Richards J, De Hert M, Probst M, Stubbs B. Physical activity correlates in people living with HIV/AIDS: a systematic review of 45 studies. Disabil Rehabil 2017; 40:1618-1629. [PMID: 28325087 DOI: 10.1080/09638288.2017.1306587] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Understanding barriers and facilitators of physical activity participation in persons living with HIV/AIDS is an essential first step in order to devise effective interventions. The present review provides a systematic quantitative review of the physical activity correlates in people with HIV/AIDS. METHODS Major electronic databases were searched till August 2016. Keywords included "physical activity" or "exercise" or "sports" and "AIDS" or "HIV". RESULTS Out of 55 correlates from 45 studies (N = 13,167; mean age range = 30.5-58.3 years; 63.2% male) five consistent (i.e., reported in four or more studies) correlates were identified. Lower levels of physical activity were consistently associated with older age (6/10 studies), a lower educational level (6/7), a lower number of CD4 cells/μl (7/11), exposure to antiviral therapy (4/6), and the presence of lipodystrophy (4/4). Other important barriers were the presence of bodily pain (2/2), depression (3/3), and opportunistic infections (3/4). Facilitators were a higher cardiorespiratory fitness level (3/3), a higher self-efficacy (2/2), more perceived benefits (2/2), and a better health motivation (3/3). CONCLUSIONS The current review has elucidated that participation in physical activity by people with HIV/AIDS is associated with a range of complex factors which should be considered in rehabilitation programs. Implications for Rehabilitation Health care professionals should consider HIV-related bodily pain and feelings of depression when assisting people living with HIV in inititiating and maintaining an active lifestyle. Interventions to improve self-efficacy and motivation, and to help people living with HIV in understanding the benefits of exercise, may encourage greater participation.
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Affiliation(s)
- Davy Vancampfort
- a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium.,b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven-Kortenberg , Belgium
| | - James Mugisha
- c Butabika National Referral and Mental Health Hospital , Kampala , Uganda.,d Department of Sociology and Social Administration, Kyambogo University , Kampala , Uganda
| | - Justin Richards
- e School of Public Health & Charles Perkins Centre , University of Sydney , Sydney , NSW , Australia
| | - Marc De Hert
- b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven-Kortenberg , Belgium
| | - Michel Probst
- a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium
| | - Brendon Stubbs
- f Department of Physiotherapy , South London and Maudsley NHS Foundation Trust , London , UK.,g Department of Health Service and Population Research , King's College London , De Crespigny Park , London , UK
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Vancampfort D, Mugisha J, De Hert M, Probst M, Firth J, Gorczynski P, Stubbs B. Global physical activity levels among people living with HIV: a systematic review and meta-analysis. Disabil Rehabil 2016; 40:388-397. [PMID: 27929355 DOI: 10.1080/09638288.2016.1260645] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE It is unclear how much physical activity people living with HIV (PLWH) engage in. We conducted a meta-analysis to investigate physical activity levels and its predictors in PLWH. METHODS PubMed, PsycARTICLES, and CINAHL Plus were searched by two independent reviewers from inception till 1 April 2016 using the keywords: "HIV" OR "AIDS" AND "physical activity" OR "exercise" OR "sports". A random effects meta-analysis was conducted. RESULTS Across 24 studies including 34 physical activity levels there were 3780 (2471♂) PLWH (mean age range: 37-58 years). PLWH spent 98.9 (95%CI = 64.8-133.1) minutes per day being physically active which is lower than in most other populations with chronic diseases. 50.7% (95%CI = 39.3-62%) (n = 2052) of PLWH complied with the physical activity guidelines of 150 min moderate intensity physical activity per week. The number of steps walked per day in 252 PLWH was 5899 (95%CI = 5678-6418), which is below the 10,000 steps per day recommendation. CONCLUSIONS Our data demonstrate that a considerable proportion of PLWH are insufficiently physically active. Future lifestyle interventions specifically targeting the prevention of physical inactivity in PLWH are warranted. Implications for Rehabilitation Many people living with HIV do not comply with general health recommendations. Physical activity counseling should be key in the rehabilitation of people living with HIV.
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Affiliation(s)
- Davy Vancampfort
- a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium.,b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven , Kortenberg , Belgium
| | - James Mugisha
- c Butabika National Referral and Mental Health Hospital , Kampala , Uganda.,d Kyambogo University , Kampala , Uganda
| | - Marc De Hert
- b University Psychiatric Center KU Leuven, KU Leuven - University of Leuven , Leuven , Kortenberg , Belgium
| | - Michel Probst
- a Department of Rehabilitation Sciences , KU Leuven - University of Leuven , Leuven , Belgium
| | - Joseph Firth
- e Institute of Brain, Behaviour and Mental Health , University of Manchester , Manchester , UK
| | - Paul Gorczynski
- f Department of Sport and Exercise Science , University of Portsmouth , Portsmouth , Hampshire , UK
| | - Brendon Stubbs
- g Department of Physiotherapy , South London and Maudsley NHS Foundation Trust , London , UK.,h Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience , King's College London , London , UK
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Mashinya F, Alberts M, Colebunders R, Van Geertruyden JP. Weight status and associated factors among HIV infected people on antiretroviral therapy in rural Dikgale, Limpopo, South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-e8. [PMID: 28155318 PMCID: PMC5153409 DOI: 10.4102/phcfm.v8i1.1230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/12/2016] [Accepted: 09/08/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Underweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD). AIM The study determined weight status and associated factors in people with HIV infection receiving ART. SETTING Rural primary health care clinics in Dikgale, Limpopo province, South Africa. METHODS A cross-sectional study in which data were collected using the World Health Organization (WHO) stepwise approach to surveillance (STEPS) questionnaire and calculated using WHO analysis programmes guide. Weight and height were measured using standard WHO procedures, and body mass index was calculated as weight (kg)/height (m2). Data on ART duration were extracted from patients' files. CD4 lymphocyte counts and viral load were determined using standard laboratory techniques. RESULTS Of the 214 participants, 8.9%, 54.7% and 36.4% were underweight, normal weight and overweight, respectively. Physical activity (OR: 0.99, p = 0.001) and male gender (OR: 0.29, p = 0.04) were negatively associated with overweight. Men who used tobacco were more likely to be underweight than non-tobacco users (OR: 10.87, p = 0.02). Neither ART duration nor viral load or CD4 count was independently associated with underweight or overweight in multivariate analysis. CONCLUSION A high proportion of people on ART were overweight and a smaller proportion underweight. There is a need to simultaneously address the two extreme weight problems in this vulnerable population through educating them on benefits of avoiding tobacco, engaging in physical activity and raising awareness of CVD risk.
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Affiliation(s)
- Felistas Mashinya
- Department of Pathology and Medical Science, Faculty of Health Sciences, University of Limpopo.
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Gouvêa-e-Silva LF, Said RDC, Kietzer KS, Freitas JJDS, Xavier MB. NÍVEL DE ATIVIDADE FÍSICA E SÍNDROME LIPODISTRÓFICA EM PACIENTES COM HIV/AIDS. REV BRAS MED ESPORTE 2016. [DOI: 10.1590/1517-869220162202138767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introdução: A atividade física pode ser uma aliada para minimizar o surgimento da lipodistrofia e seus efeitos deletérios. Objetivo: Analisar a relação do nível de atividade física (NAF) e a síndrome lipodistrófica com a composição corporal e a qualidade de vida (QV) de portadores do HIV/Aids. Métodos: Participaram do estudo 120 pacientes com HIV/Aids (38,55 ± 11,47 anos). Foram avaliados quanto ao índice de massa corporal, composição corporal, taxa metabólica basal, índice cintura-quadril, QV, presença, tipo e local de lipodistrofia, força de preensão manual e NAF. Resultados: Constatou-se que 70% eram sedentários; além disso, a massa magra foi 9,5% maior nos pacientes ativos, bem como a força muscular de preensão com a mão direita (11%) e esquerda (12%) e a taxa metabólica basal (6,9%). Quanto à associação da QV ao NAF, foi notada correlação fraca apenas para a preocupação com o sigilo (r = 0,2160; p = 0,0210), bem como, os pacientes ativos demonstraram melhor resultado que os sedentários (p < 0,05). Dos pacientes que apresentaram lipodistrofia, 66% eram sedentários; o tipo predominante foi a lipodistrofia mista (46%) e as regiões mais comuns foram a face e abdome. Ressalta-se que nos pacientes sem a síndrome a taxa metabólica basal foi maior (p = 0,0175) e o tempo de infecção (p = 0,0020) e de TARV (p = 0,0002) foram menores. Conclusão: Conclui-se, conforme metodologia adotada, que o sedentarismo predominou, o NAF apresentou associação positiva somente com a preocupação com o sigilo e os sedentários apresentaram dois domínios abaixo do escore de 50 (preocupação financeira e com o sigilo), com relação a um domínio dos pacientes ativos. A lipodistrofia esteve presente em 37% da amostra, sendo o tipo mais presente a lipodistrofia mista, e os locais de maior ocorrência foram a face e o abdome. Para esse grupo o NAF não se apresentou positivo para a composição corporal e a presença da lipodistrofia não influenciou na QV.
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Lifestyle Medicine and HIV-Infected Patients. LIFESTYLE MEDICINE 2016. [DOI: 10.1007/978-3-319-24687-1_32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Fazeli PL, Marquine MJ, Dufour C, Henry BL, Montoya J, Gouaux B, Moore RC, Letendre. SL, Woods SP, Grant I, Jeste DV, Moore DJ. Physical Activity is Associated with Better Neurocognitive and Everyday Functioning Among Older Adults with HIV Disease. AIDS Behav 2015; 19:1470-7. [PMID: 25731660 PMCID: PMC4527965 DOI: 10.1007/s10461-015-1024-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We examined the association between physical activity (PA), neurocognitive impairment (NCI), and instrumental activities of daily living (IADLs) among older HIV+ persons. One hundred older HIV+ adults completed the International Physical Activity Questionnaire, a neurocognitive battery, and IADL scale. Higher levels of moderate PA were associated with lower odds of NCI (p = 0.01), even when covariates were modeled. The association between moderate PA and NCI was driven by executive function (p = 0.04). Higher levels of moderate PA were also associated with lower odds of IADL Dependence (p = 0.03), although this fell to a trend (p = 0.08) when including covariates. Follow-up analysis showed those with both NCI and IADL Dependence had lower moderate PA than those with neither (p = 0.03). While these cross-sectional findings suggest PA is associated with better neurocognitive and everyday functioning in older HIV+ adults, longitudinal studies utilizing objective PA methods are needed to evaluate directionality and mechanisms.
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Affiliation(s)
- Pariya L. Fazeli
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Maria J. Marquine
- Department of Psychiatry, University of California San Diego, San Diego, CA
- Stein Institute for Research on Aging, University of California San Diego, San Diego, CA
| | - Catherine Dufour
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Brook L. Henry
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Jessica Montoya
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA
| | - Ben Gouaux
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Raeanne C. Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA
- Stein Institute for Research on Aging, University of California San Diego, San Diego, CA
| | - Scott L. Letendre.
- Department of Medicine, University of California San Diego, San Diego, CA
| | | | - Igor Grant
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, San Diego, CA
- Stein Institute for Research on Aging, University of California San Diego, San Diego, CA
| | - David J. Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA
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Tanaka LF, Latorre MDRDDO, Silva AM, Konstantyner TCRDO, Peres SV, Marques HHDS. [High prevalence of physical inactivity among adolescents living with HIV/Aids]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:327-32. [PMID: 25907024 PMCID: PMC4620960 DOI: 10.1016/j.rpped.2014.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 12/03/2014] [Accepted: 12/25/2014] [Indexed: 11/17/2022]
Abstract
Objective: To assess the prevalence of physical inactivity among adolescents with HIV/AIDS,
as well as associated factors. Methods: Ninety-one adolescents (from 10 to 19 years old) with HIV/AIDS who are patients at
a university follow-up service were interviewed. Anthropometric data (weight,
height, and waist circumference) were measured twice; clinical information was
obtained from medical records, and habitual physical activity was assessed by a
questionnaire proposed by Florindo et al. The cutoff point for sedentariness was
300 minutes/week. Results: The prevalence of inadequate height for age, malnutrition, and overweight/obesity
was 15.4%, 9.9% and 12.1%, respectively. The most common physical activities were
soccer (44.4%), volleyball (14.4%) and cycling (7.8%). The median times spent with
physical activity and walking/bicycling to school were 141 min and 39 min,
respectively. Most adolescents (71.4%) were sedentary and this proportion was
higher among girls (p=0.046). Conclusions: A high prevalence of physical inactivity among adolescents with HIV/AIDS was
observed, similar to the general population. Promoting physical activity among
adolescents, especially among girls with HIV/AIDS, as well as monitoring it should
be part of the follow-up routine of these patients.
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Affiliation(s)
- Luana Fiengo Tanaka
- Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil.
| | | | - Aline Medeiros Silva
- Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brasil
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HIV/AIDS and lipodystrophy: implications for clinical management in resource-limited settings. J Int AIDS Soc 2015; 18:19033. [PMID: 25598476 PMCID: PMC4297925 DOI: 10.7448/ias.18.1.19033] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 10/11/2014] [Accepted: 10/30/2014] [Indexed: 12/11/2022] Open
Abstract
Introduction Lipodystrophy is a term used to describe a metabolic complication of fat loss, fat gain, or a combination of fat loss and gain, which is associated with some antiretroviral (ARV) therapies given to HIV-infected individuals. There is limited research on lipodystrophy in low- and middle-income countries, despite accounting for more than 95% of the burden of HIV/AIDS. The objective of this review was to evaluate the prevalence, pathogenesis and prognosis of HIV-related lipoatrophy, lipohypertrophy and mixed syndrome, to inform clinical management in resource-limited settings. Methods We conducted a structured literature search using MEDLINE electronic databases. Relevant MeSH terms were used to identify published human studies on HIV and lipoatrophy, lipohypertrophy, or mixed syndrome in low-, low-middle- and upper-middle-income countries through 31 March 2014. The search resulted in 5296 articles; after 1599 studies were excluded (958 reviews, 641 non-human), 3697 studies were extracted for further review. After excluding studies conducted in high-income settings (n=2808), and studies that did not meet inclusion criteria (n=799), 90 studies were included in this review. Results and Discussion Of the 90 studies included in this review, only six were from low-income countries and eight were from lower middle-income economies. These studies focused on lipodystrophy prevalence, risk factors and side effects of antiretroviral therapy (ART). In most studies, lipodystrophy developed after the first six months of therapy, particularly with the use of stavudine. Lipodystrophy is associated with increased risk of cardiometabolic complications. This is disconcerting and anticipated to increase, given the rapid scale-up of ART worldwide, the increasing number and lifespan of HIV-infected patients on long-term therapy, and the emergence of obesity and non-communicable diseases in settings with extensive HIV burden. Conclusions Lipodystrophy is common in resource-limited settings, and has considerable implications for risk of metabolic diseases, quality of life and adherence. Comprehensive evidence-based interventions are urgently needed to reduce the burden of HIV and lipodystrophy, and inform clinical management in resource-limited settings.
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Godoy-Santos AL, Bordalo-Rodrigues M, Rosemberg L, Fernandes TD, Lima ALLM, Camanho GL, Maffulli N. Kager's fat pad inflammation associated with HIV infection and AIDS: MRI findings. Skeletal Radiol 2014; 43:1257-62. [PMID: 25027638 DOI: 10.1007/s00256-014-1931-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 04/11/2014] [Accepted: 05/29/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe magnetic resonance imaging (MRI) features of Kager's fat pad inflammation in HIV-positive patients with lipodystrophy due to protease inhibitor treatment and posterior ankle pain. METHODS A case-control, cross-sectional study; group 1 included 14 HIV-positive patients using protease inhibitors, presenting lipodystrophy syndrome and having posterior ankle pain; group 2 (CGHIV-) included 112 HIV-negative patients without lipodystrophy syndrome who were being evaluated for posterior ankle pain; group 3 (CGHIV + 1) included 23 HIV-positive patients not using a protease inhibitor, without lipodystrophy syndrome and with posterior ankle pain; group 4 (CGHIV + 2) comprised 18 HIV-positive patients who were being treated with a protease inhibitor and had lipodystrophy syndrome but did not have posterior ankle pain. Images were evaluated for the presence of edema by two radiologists who were blinded to clinical features. Fisher's exact test was used to evaluate differences among the groups. Interobserver variation was tested using Cohen's kappa (κ) statistic. RESULTS The presence of edema within Kager's fat pad was strongly associated with symptoms in HIV-positive patients who had lipodystrophy (p ≤ 0.0001). Concordance between observers was excellent (κ > 0.9). CONCLUSION MRI findings of Kager's fat pad inflammation related to HIV/AIDS is a source of symptoms in HIV patients with posterior ankle pain using protease inhibitors and having lipodystrophy syndrome.
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Affiliation(s)
- Alexandre Leme Godoy-Santos
- Department of Orthopedic Surgery, University of São Paulo, Rua Ovídio Pires de Campos 333 Cerqueira Cesar, São Paulo, SP, 05403-010, Brazil,
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Della Justina LB, Luiz MC, Maurici R, Schuelter-Trevisol F. Prevalence and factors associated with lipodystrophy in AIDS patients. Rev Soc Bras Med Trop 2014; 47:30-7. [DOI: 10.1590/0037-8682-0240-2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 01/28/2014] [Indexed: 12/13/2022] Open
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Pinto Neto LFDS, Milanez MDC, Golub JE, Miranda AEB. Malignancies in HIV/AIDS patients attending an outpatient clinic in Vitória, State of Espírito Santo, Brazil. Rev Soc Bras Med Trop 2013; 45:687-90. [PMID: 23295869 DOI: 10.1590/s0037-86822012000600006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 09/19/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The present study investigated cancer prevalence and associated factors among HIV-infected individuals attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. METHODS A sectional study was conducted among HIV infected adults attending an AIDS outpatient clinic in Vitória, State of Espírito Santo, Brazil. Demographic, epidemiological and clinical data were abstracted from medical records, including cancer diagnoses; nadir and current CD4 cell count, HIV viral load, time on antiretroviral treatment (ART), type of ART and smoking status. RESULTS A total of 730 (91.3%) patients were included in the study. Median age was 44.0 [interquartile range (IQR): 35-50.3] years; median time since HIV diagnosis was 5.5 years (IQR: 2-10); 60% were male; and 59% were white. Thirty (4.1%) cases of cancer were identified of which 16 (53%) were AIDS defining cancers and 14 (47%) were non-AIDS defining malignancies. Patients diagnosed with cancer presented higher chance of being tobacco users [OR 2.2 (95% CI: 1.04-6.24)]; having nadir CD4 ≤200 cells/mm³ [OR 3.0 (95% CI: 1.19-7.81)] and higher lethality [OR 13,3 (95% CI: 4,57-38,72)]. CONCLUSIONS These results corroborate the importance of screening for and prevention of non-AIDS defining cancers focus in HIV-infected population, as these cancers presented with similar frequency as AIDS defining cancers.
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Scleredema in a Patient with AIDS-Related Lipodystrophy Syndrome. Case Rep Endocrinol 2013; 2013:943798. [PMID: 23365768 PMCID: PMC3556400 DOI: 10.1155/2013/943798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 12/27/2012] [Indexed: 11/25/2022] Open
Abstract
Scleredema is a form of cutaneous mucinosis caused by an increased accumulation of collagen and mucin in the dermis. It is characterized by diffused, nonpitting swelling and induration of the skin. Scleredema diabeticorum is one type of scleredema associated with diabetes mellitus. AIDS-related insulin resistance and lipodystrophy syndrome are a newly emerging entities in HIV-infected patients associated with severe metabolic disturbances and insulin resistance. The long-standing diabetes in these patients may contribute to the development of scleredema diabeticorum. Here, we report the rare occurrence of scleredema in an HIV-infected patient with AIDS-related lipodystrophy syndrome.
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