International AIDS Society

HIV+ Children Have Lower Exercise Capacity, Strength Than HIV- Group

Author: Mark Mascolini

04 February 2013

Compared with HIV-negative children, US teens with HIV had significantly lower estimated peak oxygen consumption (VO2 peak), flexibility, and strength. Greater body fat and longer time taking antiretroviral therapy (ART) were associated with VO2 peak.

Poor physical fitness resulting from a sedentary lifestyle and obesity affect many children in high-income countries. HIV and antiretroviral therapy may further compromise fitness in children with HIV. University of Miami researchers conducted this study to compare peak oxygen consumption (VO2 peak), flexibility, and strength in 45 HIV-positive children and 36 healthy HIV-negative controls.

The HIV group was older than the HIV-negative group (average 16.1 versus 13.5 years). Thirty-seven HIV-positive children (82%) were taking combination antiretroviral therapy (ART). HIV-positive children had a median viral load of 980 copies/mL (interquartile range [IQR] 200 to 11,000 copies/mL) and a median CD4 percent of 28% (IQR 15% to 35%).

Statistical analysis adjusted for age, sex, race, body fat, and siblingship determined that HIV-positive children had significantly lower VO2 peak (25.92 vs 30.90 mL/kg/min, P <0.0001), flexibility (23.71% vs 46.09%, P = 0.0003), and lower-extremity strength-to-weight ratio (0.79 vs 1.10 kg lifted/kg of body weight, P = 0.002).

Among children with HIV, statistical analysis adjusted for age, sex, race, percent body fat, and viral load showed VO2 peak was 0.30 mL/kg/min lower per unit increase in percent body fat (P < 0.0001).

The same analysis determined that VO2 peak decreased significantly with longer antiretroviral exposure: 29.45 mL/kg/min for no ART, 28.70 mL/kg/min for under 30 months, and 24.09 mL/kg/min for 60 months or longer (P <0.0001).

The authors call for further studies “that elucidate the understanding of these differences and mechanisms of decreased physical fitness.”

Previous work by the same investigators found that a supervised hospital-based fitness program can safely improve general fitness, strength, and lean body mass in children with HIV (Miller TL, et al. AIDS Research and Human Retroviruses. 2010; 26: 313-319, linked below).

Source: Gabriel Somarriba, Gabriela Lopez-Mitnik, David A. Ludwig, Daniela Neri, Natasha Schaefer, Steven E. Lipshultz, Gwendolyn B. Scott, Tracie L. Miller. Physical fitness in children infected with the human immunodeficiency virus: associations with highly active antiretroviral therapy. AIDS Research and Human Retroviruses. 2013; 29: 112-120.

For the study abstract

(Downloading the complete article requires a subscription to AIDS Research and Human Retroviruses or an online payment; the abstract is free.)

For the Miller article