Muscle strength in young children perinatally infected with HIV who were initiated on antiretroviral therapy early

Background. As children with perinatally acquired HIV (PHIV) are living longer, long-term physical sequelae of the disease are becoming more pertinent. Muscle strength is known to be adversely affected in adults infected with HIV but little is known about the muscle strength of children with PHIV. Objectives. To determine the muscle strength of children perinatally infected with HIV compared with an uninfected control group. Associations between clinical and anthropometric variables and muscle strength were investigated. Methods. In this cross-sectional descriptive study, 175 children who acquired HIV perinatally and 171 children who were HIV-uninfected had their muscle strength assessed by hand-held dynamometry and the ‘make test’. Clinical data were extracted from the children’s clinic files. Height and weight were assessed using a stadiometer and a digital scale, respectively. Children were between the ages of 5 and 11 years of age at assessment. The children living with HIV had all been initiated on antiretroviral treatment (ART) at a young age (mean (standard deviation (SD)) 8.7 (6.7) months) and their disease was well controlled. Results. Despite the children with HIV presenting with significantly lower height, weight and body mass index (BMI) for age z-scores, there was no statistical difference in muscle strength between the two groups. BMI and Tanner staging were associated with muscle strength in both groups. Conclusions. Children who are initiated on ART at an early age and whose disease is well controlled are able to attain near-normal muscle strength. Longitudinal follow-up of these children as they go through puberty is warranted.