A systematic review of sarcopenia prevalence and associated factors in people living with human immunodeficiency virus

Abstract

People living with human immunodeficiency virus (HIV) (PLWH) appear to be at an increased risk of sarcopenia, which can have a devastating effect on their life due to consequences such as physical disability, poor quality of life, and finally death. This systematic review examined sarcopenia prevalence and its associated factors in PLWH. A systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, Embase and Cochrane databases from the dates of inception up to May 2022. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis. Data relating to the study population, purpose of study, gender, age, race, body mass index, medical history, paraclinical results and antiretroviral therapy as associated factors of sarcopenia were extracted. In addition, the prevalence of sarcopenia in PLWH and its promoting and reducing factors were also extracted. We reviewed the 14 related studies for identifying of sarcopenia prevalence and its associated factors in PLWH. The total number of PLWH in all the reviewed studies was 2592. There was no criterion for the minimum number of people with HIV and the lowest number of PLWH was 27, and the highest number was 860. Some studies reported a significantly higher prevalence of sarcopenia in HIV-infected individuals compared with HIV-negative controls as follows: 24.2-6.7%, 15-4% and 10-6%, respectively. We showed that, age (30-50 years), being female, >5 years post-HIV diagnosis, multiple vertebral fractures, cocaine/heroin use and lower gamma-glutamyl transferase level were the main promoting factors of sarcopenia. Higher educational level, employment, physical exercise, calf circumference >31 cm, and gait speed >0.8 m/s were also factors to reduce sarcopenia. Sarcopenia prevalence in PLWH is higher than HIV-negative population. Given the importance and prevalence of sarcopenia among PLWH and its associated consequences (i.e., mortality and disability), determining its risk factors is of great importance.

Prevalence of sarcopenia in Africa: a systematic review and meta-analysis of observational studies

“…Finally, we were not able to explore as moderators of our findings some medical conditions, more frequent in Africa, such as infectious diseases that may affect our results. For example, it was reported by some investigations that the prevalence of sarcopenia in AIDS is extremely high [ 39 ] and AIDS is extremely common in this continent [ 40 ].…”

Exploring the Interplay between Bone Marrow Stem Cells and Obesity

“…More fractures in the ankle, leg, humerus, and vertebral column and fewer in the wrist, hip, and pelvis occur in obese women. In conclusion, the evidence currently available indicates that obesity raises the risk of falls and multiple falls in individuals over 60, who are at a higher risk of experiencing lasting disability and having a lower quality of life [ 59 , 60 , 61 , 62 , 63 ]. On the other hand, the evidence linking obesity to fall-related injuries or fractures is weaker.…”

“…Another cytokine with a variety of functions is IL-6. Adipocytes and fibroblasts are among the cells that upregulate its production [ 62 ] in response to obesity and insulin resistance [ 63 ]. Like TNFα, IL-6 stimulates bone resorption and osteoclast genesis.…”

Drug‐related sarcopenia as a secondary sarcopenia

“…Elevations in serum CK, if any, are mild and intermittent (Table 1). 58 Patients with HIV have long been noted to be more prone to sarcopenia, and one factor may be the long‐term use of antiviral medications 59 …”

“…58 Patients with HIV have long been noted to be more prone to sarcopenia, and one factor may be the long-term use of antiviral medications. 59 Prolonged use of zidovudine increases ROS production and oxidative stress by disrupting the electron transport chain, resulting in mitochondria dysfunction. 3 Recently, tenofovir-based regimen, a nucleoside analogue other than a zidovudine-based regimen, has been reported to induce myopathy in patients with HIV as well.…”