Age-Related Declines in Physical Function No More Common in HIV

People living with HIV are no more likely than their HIV-negative peers to experience age-related declines in physical functioning—a problem tied to poorer health in older people—according to a study published in the January issue of AIDS Patient Care and STDs.

Researchers have found in recent years that a number of age-related diseases appear to be occurring in HIV-positive people at a younger age than their HIV-negative counterparts. There is disagreement, however, about whether these conditions—including cardiovascular disease (CVD), bone mineral loss, pulmonary diseases and certain cancers—are signs of accelerated aging or other factors associated with HIV infection.

Nevertheless, scientists are eager to better understand the phenomenon of aging-related diseases in HIV and to determine the best ways to care for an aging HIV population. The majority of people with HIV are expected to be older than 50 by the year 2015.

One area of interest is physical functioning. Physical functioning comprises a number of aspects of a person’s physical ability to carry out tasks, ranging from daily chores to strenuous exercise. In HIV-negative people, defects in physical function have been associated with greater risks of illness and death. Few studies, however, have tried to assess whether reduced physical function is more common in people with HIV at a younger age.

To explore this area, Krisann Oursler, MD, ScM, from the University of Maryland School of Medicine and the Veterans Affairs (VA) Maryland Healthcare System in Baltimore, and her colleagues from other centers around the United States, compared data on 3,227 HIV-positive and 3,240 HIV-negative military veterans. Most of the study participants were male, and the majority were 45 or older.

The two groups differed in certain key respects. HIV-positive participants were less likely to report regular exercise, tended to be more underweight, to have a history of injection drug use and to be more likely to have a range of health conditions including CVD, hepatitis C virus (HCV) infection and diabetes.

Of note, when Oursler’s team accounted for these differing factors, there were no significant differences overall in physical function between HIV-positive and HIV-negative participants.

This also generally held true when the researchers looked only at people with a variety of other serious illnesses. HIV-positive people with CVD and diabetes were no more likely to have reduced physical function than HIV-negative people with those diseases. Among obese study participants, it was the HIV-negative volunteers who were more likely to have reduced physical function. The one disease wherein people with HIV were more likely to have reduced physical function compared with HIV-negative participants was chronic lung disease. HIV-positive sufferers of this condition, which includes emphysema, were more likely to have reduced physical function than HIV-negative sufferers.

The authors note that they did not have the ability to explore levels of physical functioning as they related to the severity of specific diseases—such as CVD or diabetes—over time. They also state that further research will be needed to confirm their findings.

Nevertheless, they remark that the primary differences in physical function between HIV-positive and HIV-negative people appear not to be related to HIV, but to other illnesses. “The study supports further integration of primary health care and prevention into HIV care with increased focus on age-associated comorbidity,” they conclude.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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