Youth living with perinatally-acquired HIV have lower physical activity levels as they age compared to HIV-exposed uninfected youth.

BACKGROUND Few studies have evaluated physical activity patterns or their association with vascular inflammation among youth living with perinatally-acquired HIV (YPHIV). METHODS We assessed YPHIV and youth perinatally HIV-exposed but uninfected (YPHEU) in the PHACS Adolescent Master Protocol with at least one Block physical activity questionnaire (PAQ) completed between ages 7-19 years. Physical activity metrics were: 1) daily total energy expenditure (TEE); 2) physical activity duration (PAD) defined as the minutes of daily moderate and vigorous activity. In a subgroup, we measured serum biomarkers of coagulation (fibrinogen, P-selectin) and endothelial dysfunction (sICAM, sVCAM, E-selectin) obtained within 3 months of a single PAQ. Repeated measures linear regression models were used to compare the trajectories of log-transformed TEE and PAD by HIV status, adjusting for confounders. Spearman correlations were calculated to assess the relationship of TEE and PAD with vascular biomarkers. RESULTS 596 youth (387 YPHIV, 209 YPHEU) completed 1552 PAQs (median PAQs completed=3). Median age at enrollment (Q1, Q3) was 11 (9, 13) years. TEE and PAD increased with age in both YPHIV and YPHEU. However, even after adjusting for confounders, YPHIV had significantly less increase per year than YPHEU for TEE (5.7% [95% Confidence Interval (CI): -9.9%, -1.4%, p=0.010] less) and PAD (5.2% [95%CI: -9.2%, -1.1%, p=0.016] less). Among 302 youth with biomarker measures (187 YPHIV, 114 YPHEU), we observed little correlation with TEE or PAD. CONCLUSIONS Both groups had increases in physical activity levels as they aged, but YPHIV had smaller increases throughout adolescence compared to YPHEU, which may impact long-term health.