Antiretroviral initiation is associated with increased skeletal muscle area and fat content.

TitleAntiretroviral initiation is associated with increased skeletal muscle area and fat content.
Publication TypeJournal Article
Year of Publication2017
AuthorsErlandson KM, Fiorillo S, Masawi F, Scherzinger A, McComsey GA, Lake JE, Stein JH, Currier JS, Brown TT
JournalAIDS
Volume31
Issue13
Pagination1831-1838
Date Published2017 Aug 24
ISSN1473-5571
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; 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.

DOI10.1097/QAD.0000000000001558
Alternate JournalAIDS
PubMed ID28590329
PubMed Central IDPMC5533189
Grant ListUM1 AI069424 / AI / NIAID NIH HHS / United States
K23 AG050260 / AG / NIA NIH HHS / United States
UM1 AI069471 / AI / NIAID NIH HHS / United States
K24 AI056933 / AI / NIAID NIH HHS / United States
K24 AI120834 / AI / NIAID NIH HHS / United States
R01 AG054366 / AG / NIA NIH HHS / United States
R01 HL095126 / HL / NHLBI NIH HHS / United States
R01 HL095132 / HL / NHLBI NIH HHS / United States
K23 AI110532 / AI / NIAID NIH HHS / United States
U01 AI069471 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States