Physical function, grip strength and frailty in people living with HIV in sub‐Saharan Africa: systematic review

Objective To present the current knowledge on physical function, grip strength and frailty in HIV‐infected patients living in sub‐Saharan Africa, where the phenomenon is largely underestimated. Methods A systematic search was conducted on MEDLINE, Scopus and African Index Medicus. We reviewed articles on sub‐Saharan African people living with HIV (PLHIV) >18 years old, published until November 2016. Results Of 537 articles, 12 were conducted in six African countries and included in this review. Five articles reported information on functional limitation and one on disability. Two of these five articles reported functional limitation (low gait speed) in PLHIV. Disability was observed in 27% and 3% of PLHIV living in rural and urban places, respectively. Two of three studies reporting grip strength reported lower grip strength (nearly 4 kg) in PLHIV in comparison with uninfected patients. One study reported that PLHIV were more likely to be frail than HIV‐uninfected individuals (19.4% vs. 13.3%), whereas another reported no statistical difference. Conclusion Decline in physical function, grip strength and frailty are now part of the burden of PLHIV living in SSA countries, but current data are insufficient to characterise the real public health dimension of these impairments. Further studies are needed to depict this major public health challenge. As this is likely to contribute to a significant burden on the African healthcare systems and human resources in the near future, a holistic care approach should be developed to inform guidelines. Objectif Présenter les connaissances actuelles sur la fonction physique, la force de préhension et la fragilité chez les patients infectés par le VIH vivant en Afrique subsaharienne où le phénomène est largement sous‐estimé. Méthodes Une recherche systématique a été menée sur Medline, Scopus et African Index Medicus. Nous avons analysé les articles sur les personnes vivant avec le VIH (PVVIH) en Afrique subsaharienne, > 18 ans, publiés jusqu'en novembre 2016. Résultats Sur 537 articles, 13 ont été menés dans six pays africains et inclus dans cette analyse. Cinq articles ont rapporté des informations sur la limitation fonctionnelle et une sur le handicap. Deux de ces 5 articles ont rapporté sur la limitation fonctionnelle (faible vitesse de la démarche) chez les PVVIH. Le handicap a été observé dans 27% et 3% des PVVIH vivant en milieu rural et urbain, respectivement. Deux des trois études rapportant sur la force de préhen