Adjusted^§ mean physical component summary (PCS) and mental component summary (MCS) scores on the Short Form-36 by self-reported severity of body fat changes at baseline and follow-up visit among HIV+ men.

§<p>All models were adjusted for age, race (white vs other), education (college vs no college), HAART use at the time of the visit, co-morbidity score, and proportion of previous post-HAART visits with plasma HIV-1 RNA (viral load) <400 copies/ml.</p><p>95% CI: 95% Confidence Interval; † p value comparing baseline to follow-up; * p value <0.05 compared within visit to category “none”</p><p>Adjusted^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0114166#nt103" target="_blank">§</a>} mean physical component summary (PCS) and mental component summary (MCS) scores on the Short Form-36 by self-reported severity of body fat changes at baseline and follow-up visit among HIV+ men.</p

Participant Characteristics at Baseline Visit (5 +/−1 years after Highly Active Antiretroviral Therapy [HAART] initiation) and Follow-up Visit (median 7.5 years later).

<p>Values presented as number (%) or median (25^th, 75^th percentile).</p><p>Co-morbidity score defined as the sum number of the following co-morbid conditions: 1) depression, 2) hypertension, 3) diabetes mellitus, 4) dyslipidemia, 5) kidney Disease, 6) liver disease, 7) cancer within 1 year.</p><p>Participant Characteristics at Baseline Visit (5 +/−1 years after Highly Active Antiretroviral Therapy [HAART] initiation) and Follow-up Visit (median 7.5 years later).</p

Change in Short Form-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) Scores: Effect of HIV & Time, Self-Perceived Body Fat Changes, and Comorbidity.

<p>95% CI: 95% confidence interval; Comorbidity score: the sum number of the following co-morbid conditions: 1) depression, 2) hypertension, 3) diabetes mellitus, 4) dyslipidemia, 5) kidney disease, 6) liver disease, 7) cancer within 1 year;</p>†<p>age at baseline;</p><p>*p<0.05;</p><p>**p<0.01;</p><p>***p<0.001.</p><p>Change in Short Form-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) Scores: Effect of HIV & Time, Self-Perceived Body Fat Changes, and Comorbidity.</p

Study design indicating the relationship between the time highly active antiretroviral therapy (HAART) was initiated, the baseline visit where the initial Short Form (SF)-36 health related quality of life (HR-QoL) questionnaire was completed, and the follow-up visit when the second questionnaire was completed.

<p>Study design indicating the relationship between the time highly active antiretroviral therapy (HAART) was initiated, the baseline visit where the initial Short Form (SF)-36 health related quality of life (HR-QoL) questionnaire was completed, and the follow-up visit when the second questionnaire was completed.</p

HIV Infection Is Associated with Increased Fatty Infiltration of the Thigh Muscle with Aging Independent of Fat Distribution

<div><p>Background</p><p>Lower muscle density on computed tomography (CT) provides a measure of fatty infiltration of muscle, an aspect of muscle quality that has been associated with metabolic abnormalities, weakness, decreased mobility, and increased fracture risk in older adults. We assessed the cross-sectional relationship between HIV serostatus, age, thigh muscle attenuation, and thigh muscle cross-sectional area (CSA).</p><p>Methods</p><p>Mean CT-quantified Hounsfield units (HU) of the thigh muscle bundle and CSA were evaluated in 368 HIV-infected and 145 HIV-uninfected men enrolled in the Multicenter AIDS Cohort Study (MACS) Cardiovascular Substudy using multivariable linear regression. Models all were adjusted for HIV serostatus, age, race, and body mass index (BMI); each model was further adjusted for covariates that differed by HIV serostatus, including insulin resistance, hepatitis C, malignancy, smoking, alcohol use, and self-reported limitation in physical activity.</p><p>Results</p><p>HIV-infected men had greater thigh muscle CSA (p<0.001) but lower muscle density (p<0.001) compared to HIV-uninfected men. Muscle density remained lower in HIV-infected men (p = 0.001) when abdominal visceral adiposity, and thigh subcutaneous adipose tissue area were substituted for BMI in a multivariable model. Muscle density decreased by 0.16 HU per year (p<0.001) of increasing age among the HIV-infected men, but not in the HIV-uninfected men (HIV x age interaction -0.20 HU; p = 0.002).</p><p>Conclusion</p><p>HIV-infected men had lower thigh muscle density compared to HIV-uninfected men, and a more pronounced decline with increasing age, indicative of greater fatty infiltration. These findings suggest that lower muscle quality among HIV-infected persons may be a risk factor for impairments in physical function with aging.</p></div

Factors Associated with Thigh Muscle Density (TMD) among HIV-infected Men.

<p>Multivariable model includes age, race, BMI plus other factors associated with TMD in univariate models.</p

Cumulative probability of AIDS by age group.

<p>Cumulative probability of AIDS by age group.</p

Pearson Correlations (r) between age, BMI, grip strength, thigh muscle cross sectional area, thigh muscle density (TMD), visceral adipose area, thigh subcutaneous adipose area and insulin resistance among HIV-infected and HIV-uninfected men.

<p>Pearson Correlations (r) between age, BMI, grip strength, thigh muscle cross sectional area, thigh muscle density (TMD), visceral adipose area, thigh subcutaneous adipose area and insulin resistance among HIV-infected and HIV-uninfected men.</p

Cumulative probability of death by age group.

<p>Cumulative probability of death by age group.</p

Cumulative probability of non-AIDS cancer by age group.

<p>Cumulative probability of non-AIDS cancer by age group.</p