Factors associated with inspiratory muscle weakness in patients with HIV-1

Background: the impact of human immunodeficiency virus type 1 (HIV-1) on lung functionis well known and associated with a reduction in pulmonary ventilation. Moreover, theuse of highly active antiretroviral therapy has been associated with mitochondrial dysfunc-tion and decreased muscle strength. However, there is scarce information about the factorsassociated with inspiratory muscle weakness in these patients.Objective: the purpose of the present study was to investigate the factors associated withinspiratory muscle weakness in patients with HIV-1.Methods: two-hundred fifty seven patients with HIV-1 were screened and categorized intotwo groups: (1) IMW+ (n = 142) and (2) IMW− (n = 115). Lung function (FEV1, FVC andFEV1/FVC), maximum inspiratory pressure, distance on the six-minute walk test and CD4cell count were assessed.Results: the mean duration of HIV infection was similar in the two groups. The follow-ing variables were significantly different between groups: mean duration of highly activeantiretroviral therapy (81 ± 12 in IMW+ versus 38 ± 13 months in IMW−; p = 0.01), and CD4cell count (327 ± 88 in IMW+ versus 637 ± 97 cells/mm3in IMW−; p = 0.02). IMW+ presentedreduced lung function (FEV1, FVC, FEV1/FVC).Conclusion: patients with IMW+ had lower distance on the six-minute walk test in com-parison to the IMW− group. The duration of highly active antiretroviral therapy, distancetraveled on the 6MWT and CD4 count were determinants of IMW in patients with HIV