Abstract
BackgroundThere is growing concern about the long-term sequelae [a condition which is the consequence of a previous disease or injury] of perinatally acquired human immunodeficiency virus (HIV). Children living with HIV (CLHIV) present with cardiopulmonary impairments and decreased physical activity which may be due to poor endurance.ObjectivesOur study aimed to investigate the sub-maximal endurance of CLHIV compared to a non-infected comparison group.MethodsIn this cross-sectional descriptive study 346 CLHIV, between ages five and eleven years, were assessed using the Six Minute Walk Test (6MWT). Blood pressure, heart rate and oxygen saturation were measured pre-test, immediately post-test and five minutes post-test. Clinical and anthropometric data were recorded. Height and weight were assessed using a stadiometer and a digital scale, respectively.Results175 CLHIV (52% female) and 171 children without HIV (46% female) participated. All children were Black African. The CLHIV all initiated antiretroviral therapy (ART) at a young age (mean 8.7 months, standard deviation 6.7) and their disease was well controlled (viral load < 1000copies/ml). There were no statistically significant differences in submaximal endurance between the two groups (p = 0.831). Age of starting ART and stunted growth were negatively associated (r = -2.8 (p = 0.019) and r = -46.1 (p = 0.027), respectively) with distance walked in the 6MWT by girls living with HIV.ConclusionCLHIV who initiate ART early with well-controlled disease are able to attain submaximal endurance levels similar to their uninfected peers.Clinical implicationsEndurance and physical activity should be monitored in CLHIV. Submaximal endurance levels may improve with age and biological maturation.
Highlights
Paediatric human immunodeficiency virus (HIV) remains a challenge globally, especially in subSaharan Africa which is home to over 90% of children living with HIV (CLHIV) (UNAIDS 2020)
Children living with HIV (CLHIV) present with cardiopulmonary impairments and decreased physical activity which may be due to poor endurance
Our study aimed to investigate the sub-maximal endurance of CLHIV compared to a non-infected comparison group
Summary
Paediatric human immunodeficiency virus (HIV) remains a challenge globally, especially in subSaharan Africa which is home to over 90% of children living with HIV (CLHIV) (UNAIDS 2020). The long-term, multisystem impact of chronic inflammation because of HIV is becoming ever more evident and may be associated with the development of new complications such as cognitive (Natukunda et al 2020) and metabolic abnormalities (Barlow-Mosha et al 2013), as well as increased risk of cardiopulmonary disease (Githinji et al 2019). There is growing concern over the long-term physical sequelae of living with HIV (Laughton et al 2013). Children living with HIV are often stunted, and wasted, and poor growth has been associated with decreased physical functioning (Brassell & Potterton 2019; Wong et al 2016). There is growing concern about the long-term sequelae [a condition which is the consequence of a previous disease or injury] of perinatally acquired human immunodeficiency virus (HIV). Children living with HIV (CLHIV) present with cardiopulmonary impairments and decreased physical activity which may be due to poor endurance
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