{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:30:47Z","timestamp":1789601447203,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T00:00:00Z","timestamp":1502668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["IP.2009.33011.004"],"award-info":[{"award-number":["IP.2009.33011.004"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009660","name":"London School of Hygiene and Tropical Medicine","doi-asserted-by":"publisher","award":["MR\/K012126\/1"],"award-info":[{"award-number":["MR\/K012126\/1"]}],"id":[{"id":"10.13039\/100009660","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Low grip strength is a marker of frailty and a risk factor for mortality among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients and other populations. We investigated factors associated with grip strength in malnourished <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients at referral to <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>, and at 12\u00a0weeks and 2\u20133\u00a0years after starting <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study involved <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected Zambian and Tanzanian participants recruited to the <jats:styled-content style=\"fixed-case\">NUSTART<\/jats:styled-content> trial when malnourished (body mass index &lt;18.5\u00a0kg\/m<jats:sup>2<\/jats:sup>) and requiring <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>. The relationship of grip strength to nutritional, infectious and demographic factors was assessed by multivariable linear regression at referral for <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a01742) and after 12\u00a0weeks (<jats:italic>n<\/jats:italic>\u00a0=\u00a0778) and 2\u20133\u00a0years of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a0273).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In analyses controlled only for sex, age and height, most nutrition and infection\u2010related variables were associated with grip strength. However, in multivariable analyses, consistent associations were seen for fat\u2010free mass index, mid\u2010upper arm circumference, haemoglobin and systolic blood pressure, and a variable association with fat mass index in men. C\u2010reactive protein and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 count had limited independent effects on grip strength, while receiving tuberculosis treatment was associated with weaker grip strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this population of originally malnourished <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients, poor grip strength was more strongly and independently associated with nutritional than with infection and inflammation variables. Programmes to improve health and survival of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> patients should incorporate nutritional assessment and management and could use grip strength as a functional indicator of improving nutrition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12929","type":"journal-article","created":{"date-parts":[[2017,7,16]],"date-time":"2017-07-16T13:12:36Z","timestamp":1500210756000},"page":"1302-1313","source":"Crossref","is-referenced-by-count":15,"title":["Nutritional status is the major factor affecting grip strength of African <scp>HIV<\/scp> patients before and during antiretroviral treatment"],"prefix":"10.1111","volume":"22","author":[{"given":"S.","family":"Filteau","sequence":"first","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"PrayGod","sequence":"additional","affiliation":[{"name":"Mwanza Medical Research Centre National Institute for Medical Research Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. L.","family":"Woodd","sequence":"additional","affiliation":[{"name":"Faculty of Epidemiology and Population Health London School of Hygiene &amp; Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Friis","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Exercise and Sports University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. C.","family":"Heimburger","sequence":"additional","affiliation":[{"name":"Vanderbilt Institute for Global Health Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. R.","family":"Koethe","sequence":"additional","affiliation":[{"name":"Vanderbilt Institute for Global Health Vanderbilt University Medical Center Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Barts &amp; the London School of Medicine Queen Mary University of London London UK"},{"name":"University of Zambia School of Medicine Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Kasonka","sequence":"additional","affiliation":[{"name":"University Teaching Hospital Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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