Agreement analysis and associated factors of SARC-F and SARC-CALF in screening of risk sarcopenia in people living with human immunodeficiency virus

Abstract

Introduction: People Living with Human Immunodeficiency Virus (PLHIV) appear to be at a higher risk of developing sarcopenia. Various factors seem to influence the risk of sarcopenia, and its prevalence may differ depending on the screening tool used. This study aimed to (i) Screen the risk of sarcopenia in PLHIV using the SARC-F and SARC–Calf and identify associated factors; (ii) Analyze the agreement between the instruments in PLHIV. Methods: Cross-sectional study including PLHIV taking antiretroviral therapy. The authors assessed sarcopenia risk using the SARC-F and SARC–Calf tools with ≥4 and ≥11 cutoff points, respectively, and a wide spectrum of variables was analyzed. Results: Participated 76 patients (44.9 ± 12.7 years). Sarcopenia risk, according to the SARC-F, was 27.6% and was associated with socioeconomic status (p = 0.004), smoking (p = 0.001), disease status (p < 0.001), opportunistic infections (p = 0.001), CD4 T-cell count (p < 0.001), Handgrip Strength (HGS) (p < 0.001), and Gait Speed (GS) (p = 0,001). Using the SARC–Calf, sarcopenia risk was 36.8% and was associated with work activity (p = 0.029), socioeconomic status (p = 0.004), smoking (p = 0.009), disease status (p < 0.001), opportunistic infections (p = 0.015), CD4 T-cell count (p = 0.002), HGS (p = 0.001), Appendicular Skeletal Muscle Mass Index (ASMMI) (p = 0.009), and GS (p < 0.001). The agreement between tools was moderate (k = 0.49). Conclusion: Sarcopenia risk, as determined by both tools, was higher in low-income PLHIV with opportunistic infections, CD4 T-cell count ≤ 200 cells/mm3, low HGS, and low GS, and lower in asymptomatic and nonsmoking individuals. The authors recommend investigating these factors in hospital and outpatient settings. The SARC–Calf proved to be more appropriate for screening sarcopenia risk in PLHIV.