Abstract
IntroductionIn the HIV-infected individuals, physical activity improves physical strength, quality of life and reduces the risk of developing non-communicable diseases. In Sub-Saharan Africa, HIV-infected patients report being less active compared to HIV-uninfected individuals. We assessed the levels and correlates of objectively measured physical activity and capacity among HIV-infected antiretroviral therapy (ART)-naive individuals compared to HIV-uninfected individuals in Mwanza, Tanzania.MethodWe conducted a cross-sectional study among newly diagnosed HIV-infected ART-naive individuals and HIV-uninfected individuals frequency-matched for age and sex. Socio-demographic data, anthropometrics, CD4 counts, haemoglobin level, and C-reactive protein (CRP) were collected. Physical activity energy expenditure (PAEE) was assessed as measure of physical activity whereas sleeping heart rate (SHR) and grip strength were assessed as measures of physical capacity. Multivariable linear regression was used to assess the correlates associated with physical activity and capacity.ResultsA total of 272 HIV-infected and 119 HIV-uninfected individuals, mean age 39 years and 60% women participated in the study. Compared to HIV-uninfected individuals, HIV-infected had poorer physical activity and capacity: lower PAEE (-7.3 kj/kg/day, 95% CI: -11.2, -3.3), elevated SHR (7.7 beats/min, 95%CI: 10.1, 5.3) and reduced grip strength (-4.7 kg, 95%CI: -6.8, -2.8). In HIV-infected individuals, low body mass index, moderate-severe anaemia, low CD4 counts and high CRP were associated with lower physical activity and capacity. In HIV-uninfected individuals, abdominal obesity and moderate anaemia were associated with lower physical activity and capacity.ConclusionHIV-infected participants had lower levels of physical activity and capacity than HIV-uninfected participants. Correlates of physical activity and capacity differed by HIV status. Management of HIV and related conditions needs to be provided effectively in health care facilities. Interventions promoting physical activity in these populations will be of importance to improve their health and reduce the risk of non-communicable diseases.
Highlights
In the HIV-infected individuals, physical activity improves physical strength, quality of life and reduces the risk of developing non-communicable diseases
Compared to HIV-uninfected individuals, HIV-infected had poorer physical activity and capacity: lower Physical activity energy expenditure (PAEE) (-7.3 kj/kg/day, 95% confidence interval (CI): -11.2, -3.3), elevated sleeping heart rate (SHR) (7.7 beats/min, 95%CI: 10.1, 5.3) and reduced grip strength (-4.7 kg, 95%CI: -6.8, -2.8)
The results found on levels of physical activity indicated by reduced PAEE in HIV-infected, complement results from other studies conducted in high-income countries showing that, HIV-infected have reduced levels of physical activity which is ranging from 19–73% due to HIV-inflammation, opportunistic infections, anaemia, metabolic complications [35,36] and under-nutrition [37]
Summary
We conducted a cross-sectional study among newly diagnosed HIV-infected ART-naive individuals and HIV-uninfected individuals frequency-matched for age and sex. This was a cross–sectional study conducted from February 2017 to February 2018 in Mwanza, Tanzania, where the prevalence of HIV infection was 7.2% [25]. The CICADA study design and prevalence of diabetes in the cohort has been published [26]. We aimed to have a sample size with adequate power to demonstrate the difference in physical activity and capacity between HIV-infected ART-naïve and HIV-uninfected individuals. Using data available from the CICADA cohort: 272 HIV-infected and 119 HIV-uninfected individuals allowed us to detect an expected difference in physical capacity indicated by grip strength of 4.2 kg (SD 6.7) [27] at significance 0.05 level and power of 0.8
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