Antiretroviral initiation is associated with increased skeletal muscle area and fat content. (24th August 2017)

• Record Type: Journal Article
• Authors: Erlandson, Kristine M.; Fiorillo, Suzanne; Masawi, Fadzai; Scherzinger, Ann; McComsey, Grace A.; Lake, Jordan E.; Stein, James H.; Currier, Judith S.; Brown, Todd T.
• Is Part Of: AIDS. Volume 31:Number 13(2017)
• Publication Date: 2017-08-24
• Subjects: aging -- frailty -- HIV -- muscle density -- skeletal muscle; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000001558
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objective: A greater burden of physical function impairment occurs in HIV-infected adults; the impact of antiretroviral therapy (ART) initiation on muscle density (less dense = more fat), a measure of muscle quality, is unknown. Design: AIDS Clinical Trials Group Study A5260s, a cardiometabolic substudy of A5257, randomized HIV-infected, ART-naive adults to ritonavir-boosted atazanavir, darunavir, or raltegravir with tenofovir/emtricitabine backbone. Single-slice abdominal computed tomography scans from baseline and week 96 were reanalyzed for total and lean muscle area and density. Methods: Two-sample t -tests described the differences between baseline and week 96 variables. Linear regression analysis was used to explore the role of a priori identified variables and potential confounders. Results: Participants ( n = 235) were mostly men (90%); 31% were Black non-Hispanic; 21% were Hispanic. Over 96 weeks, small but significant increases were seen in oblique/transverse abdominal, rectus, and psoas muscle total area (range 0.21–0.83 cm 2 ; P < 0.05) but not the lean muscle component (all P ≥ 0.33). Significant decreases in overall density, consistent with increases in fat, were seen in all muscle groups (range −0.87 to −2.4 HU; P < 0.01); for the lean muscle component, only decreases in oblique/transverse abdominal and rectus reached statistical significance ( P < 0.05). In multivariable analyses, Black race was associated with increased muscle density and female sex with decreased density; treatment arm was not associated with changes in mass or density. Conclusion: The ART-associated increase in muscle area, regardless of regimen, is likely a reflection of increased fat within the muscle. The consequences of fatty infiltration of muscle on subsequent muscle function require further investigation.