Relationship Between Poor Physical Function, Inflammatory Markers, and Comorbidities in HIV-Infected Women on Antiretroviral Therapy

Background: HIV-infected individuals may be at increased risk of poor physical function. Chronic inflammation has been associated with decreased physical function in the elderly and may also influence physical function in HIV-infected individuals. Methods: This cross-sectional study assessed physical function in 65 HIV-infected women aged 40 and older on stable antiretroviral treatment using the Short Physical Performance Battery (SPPB): a standardized test of balance, walking speed, and lower-extremity strength developed for elderly populations. The relationship between low SPPB score, selected demographic and medical characteristics, and high inflammatory biomarker profile was analyzed using Fisher's exact test and Wilcoxon rank sum test. Results: The median age of subjects was 49 years (interquartile range [IQR] 45-55), and the median CD4 T-cell count was 675 cells/mm(3) (IQR 436-828). Thirteen subjects (20%) had a low SPPB score. Subjects with a low SPPB score were more likely to be cigarette smokers (p = 0.03), had more medical comorbidities (p = 0.01), and had higher levels of interleukin-6 (IL-6) (p < 0.05). They also tended to be older (median age 55 vs. 48, p = 0.06), more likely to have diabetes (p = 0.07), and have higher levels of soluble tumor necrosis factor-1 (p = 0.09). Conclusions: Twenty percent of women aged 40 and older with well-treated HIV had poor physical-function performance, which was associated with the high burden of comorbidities in this population and with increased IL-6. However, it is unclear from this cross-sectional study whether increased inflammation was related to poor physical function or to other factors, such as age and medical comorbidities.