Does antiretroviral therapy change the relationship between body composition and muscle strength in children and adolescents diagnosed with HIV?

摘要

Background: HIV infection and prolonged use of antiretroviral therapy (ART) can impact the body composition and muscle strength of HIV-infected children and adolescents. Therefore, the aim was to verify the association between lean soft tissue mass (LSTM) and handgrip strength (HGS) in children and adolescents diagnosed with HIV using or not using ART (with or without protease inhibitors [PI]). Method: Cross-sectional study with 65 children and adolescents diagnosed with HIV aged 8-15 years of both sexes. LSTM was obtained through dual X-ray absorptiometry (DXA) and HGS using hydraulic dynamometer. Information on viral load, CD4+ T lymphocytes and type of ART (with or without [PI]) were obtained from medical records. Simple and multiple linear regression (adjusted for viral load and CD4+ T lymphocytes) was used, with p < 0.05. Results: For children and adolescents diagnosed with HIV using ART without PI, the model (LSTM, viral load and CD4+ T lymphocytes) explained 68% of HGS variability. For group with ART and PI, the model explained 73%. For group that did not use ART, the model was not associated with HGS. Conclusion: The magnitude of the association between LSTM and HGS was greater than in children and adolescents using ART with PI.Impact It is recognized that in the long-term antiretroviral drugs can negatively impact the body composition of children and adolescents diagnosed with HIV. However, few studies have investigated the short-term impact of drug use. The use of antiretroviral therapy (ART) with protease inhibitor (PI) increased the explanatory power of lean soft tissue mass with muscle strength in children and adolescents diagnosed with HIV. These results demonstrate the importance of antiretroviral drugs in the short term. Further studies are needed to identify how and when interventions are needed to reduce the negative effects of drugs in the long term.