Online Journal of Clinical and Medical Case Reports · Mar 30, 2026

Muscle Wasting in HIV: Cross-Sectional Assessment of Sarcopenia in ART-Treated Adults

By Singh P

Background: Sarcopenia, defined as the progressive loss of muscle mass, strength, and function, is increasingly recognised among people living with HIV (PLHIV), even in younger adults. Chronic inflammation, long-standing infection, and prolonged antiretroviral therapy (ART) may accelerate muscle wasting. Despite its potential impact on quality of life, sarcopenia in PLHIV remains underexplored in India. Objectives: To estimate the prevalence of sarcopenia in ART-treated PLHIV and to evaluate the performance of the SARC-F screening tool compared with objective measures of muscle mass and function. Methods: This cross-sectional study included 171 PLHIV aged 18–60 years attending a tertiary-care hospital in Western Maharashtra between January 2023 and December 2024. Participants were screened using SARC-F, assessed for muscle strength (chair stand test), and physical performance (gait speed or 6-minute walk test). Muscle mass was measured with dual-energy X-ray absorptiometry (DEXA). Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria [1]. Logistic regression identified independent predictors. Results: Sarcopenia was identified in 47 participants (27.5%, 95% CI: 21.1–34.5). Affected individuals had significantly lower BMI, CD4 counts, and functional performance (p<0.05). Prevalence was higher among females (33.8%) than males (24.3%), though not statistically significant. The SARC-F tool demonstrated low sensitivity but high specificity, missing most sarcopenic cases. In multivariable analysis, low BMI (aOR 0.82, 95% CI: 0.71–0.96, p=0.012) and longer ART duration ≥5 years (aOR 2.45, 95% CI: 1.12–5.34, p=0.023) were independent predictors. Nearly 72% had osteopenia/osteoporosis, with some meeting criteria for osteosarcopenia.

doi.org/10.64258/3067-7130.2026.1020042Open accessBiomarkers