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Tegegne AS. Quality of Life and Associated Factors of HIV Patients Under Treatment with First Line Regimens in Public Hospitals in Amhara Region, North-West Ethiopia. Patient Prefer Adherence 2023; 17:1347-1359. [PMID: 37287512 PMCID: PMC10243354 DOI: 10.2147/ppa.s413192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
Background The availability of medication related to HIV treatment in the world is one of the substantial improvements for reaching USAID's 90-90 targets. Among the 90% of patients who have awareness about their disease, 90% are accessing their treatment and patients who received appropriate treatment have a suppressed viral load and improved CD4 cell count. Therefore, the main objective of the current study was to investigate the quality of life and associated factors of people living with HIV receiving first-line regimens at public hospitals in the Amhara region, Ethiopia. Methods A retrospective cohort study was conducted on 700 adult HIV-infected patients under treatment with first-line regimens, who were followed-up in 17 public hospitals in the Amhara region. A multivariate linear regression analysis was used for the current study. Results Of the 700 patients included in the current analyses, 59.5% (n=358) reported no impairment in self-care, while 63.1% (n=380) were extremely anxious/depressed. The overall expected EQ-5D utility score and visual analog scale (EQ-VAS) scores were 0.388 0.41 and 66.20 17.22 respectively. The current study indicated that the covariates sex, age of patient, level of education, appointment frequency, disclosure status of the disease, and substance use significantly affected the quality of life of people living with HIV and under treatment with first-line regimens. Hence, higher CD4 cell count and less detectable viral load lead to good quality of life of people living with HIV. Conclusion This study indicates that certain covariates have been identified as statistically significant predictors of the study variable "quality of life" of HIV-positive people. The findings obtained in the current investigation can help policy-makers to revise the current directives. The result obtained in this study can also help health staff to conduct health-related education during the treatment of HIV patients.
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Kaseke F, Pamire PR, Mlambo T, Nhunzvi C. Perspectives of adults living with HIV attending the opportunistic infections clinic at Chitungwiza central hospital in Zimbabwe towards physical activity: a cross-sectional survey. BMC Sports Sci Med Rehabil 2023; 15:69. [PMID: 37127685 PMCID: PMC10150463 DOI: 10.1186/s13102-023-00676-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Regular physical activity and exercise have been shown to be of benefit in managing the HIV disease, its complications and the side effects of HAART. The perceptions of those living with HIV toward physical activity and exercises is a key factor in advocating for participation of rehabilitation personnel in the management of this disease. However, this domain remains underexplored in Zimbabwe. METHODS A descriptive cross-sectional quantitative study was conducted with 327 people living with HIV. Participants were consecutively sampled from Chitungwiza Central Hospital Opportunistic Clinic. The International Physical Activity Questionnaire (IPAQ) and the Exercise Benefits/Barriers Scale (EBBS) were respectively used to measure the physical activity level and perceived benefits/barriers of physical exercise among adults living with HIV. The tools were self-administered. The analyses were done for 323 participants using the Statistical Package for the Social Sciences (SPSS). RESULTS The mean age was 41.1 ± 11.0. Females constituted 69.7% (n = 225) of the sample. The majority of participants (n = 184; 57%) described themselves as being highly physically active (3204;IQR = 2139-4441 MET-minutes/week). Most of the participants agreed that physical activity prevented heart attacks with a mean value of 3.34 ± 0.65. The majority perceived psychological outlook as the greatest benefit from physical activity among the benefit sub-scales. Furthermore, most of the participants agreed that it cost too much for them to exercise which had a mean of 3.00 ± 0.88. Family discouragement was the most agreed perceived barrier to physical activity with a mean of 2.91 ± 0.67. Those who perceived physical activity as being beneficial reported less barriers. A statistically significant association was found between level of physical activity and CD4 cell count (p = 0.035) as well as with employment status (p < 0.05). No statistically significant association was reported between the perceived benefits and the level of physical activity (p = 0.214). A statistically significant association was reported between the perceived barriers and age (p < 0.05) as well as with employment status (p = 0.006). CONCLUSION Adults living with HIV receiving HAART at Chitungwiza Central Hospital are highly active when compared to other studies done in Sub-Saharan Africa. It is also important to create interventions that promote physical activity considering what this population considers as perceived benefits and barriers to physical activity.
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Affiliation(s)
- Farayi Kaseke
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe.
| | - Precious R Pamire
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Tecla Mlambo
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Clement Nhunzvi
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
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3
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Ibeneme SC, Uwakwe VC, Myezwa H, Irem FO, Ezenwankwo FE, Ajidahun TA, Ezuma AD, Okonkwo UP, Fortwengel G. Impact of exercise training on symptoms of depression, physical activity level and social participation in people living with HIV/AIDS: a systematic review and meta-analysis. BMC Infect Dis 2022; 22:469. [PMID: 35578192 PMCID: PMC9109396 DOI: 10.1186/s12879-022-07145-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 02/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls? METHOD Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2). RESULTS Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18-86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2-3 times/week, at 40-60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = - 0.74, 95% confidence interval (CI) - 1.01, - 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI - 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI - 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants). CONCLUSION Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies. TRAIL REGISTRATION NUMBER INPLASY202040048.
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Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, 1 College Road, New Layout, Enugu, 400001, Nigeria.
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa.
- University of Nigeria, University of Nigeria Centre for Clinical Trials (UNNCET), 1 College Road, New Layout, Enugu, 400001, Nigeria.
- Department of Physiotherapy, Faculty of Health Sciences & Technology, King David University of Medical Sciences, Amasir i- Afikpo Road, Uburu, 491101, Ebonyi State, Nigeria.
| | - Victor Chukwuebuka Uwakwe
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, 1 College Road, New Layout, Enugu, 400001, Nigeria
| | - Hellen Myezwa
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa
| | - Franklin Onyedinma Irem
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, 1 College Road, New Layout, Enugu, 400001, Nigeria
| | - Fortune Elochukwu Ezenwankwo
- Division of Exercise Science and Sports Medicine, University of Cape Town/Sports Science, Institute of South Africa, Boundary Road, Newlands, Cape Town, 7725, Western Cape, South Africa
| | - Tunde Adedayo Ajidahun
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, Gauteng, South Africa
| | - Amarachi Destiny Ezuma
- Department of Physiotherapy, University of Nigeria Teaching Hospital, KM 35 Enugu Port-Harcourt Expressway, Ituku/Ozalla, 400001, Enugu, Nigeria
| | - Uchenna Prosper Okonkwo
- Department of Medical Rehabilitation, Faculty of Health Sciences, Nnamdi Azikiwe University, Okofia, Nnewi Campus, Nnewi, 435101, Anambra State, Nigeria
| | - Gerhard Fortwengel
- Fakultat III, Hochschule Hannover - University of Applied Sciences and Arts, Expo Plaza, Hannover, 30539, Lower Saxony, Germany
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Nweke M, Nombeko M, Govender N, Akinpelu AO, Ogunniyi A. Effects of aerobic exercise on quality of life of people with HIV-associated neurocognitive disorder on antiretroviral therapy: a randomised controlled trial. BMC Infect Dis 2022; 22:419. [PMID: 35488222 PMCID: PMC9055763 DOI: 10.1186/s12879-022-07389-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/13/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND HIV-associated neurocognitive disorder (HAND) negatively impacts quality of life (QoL) of people living with HIV who are on antiretroviral therapy (ART). Behavioural intervention adjunct to ART may improve QoL of people with HAND. We determine the effect of a 12-week aerobic exercise programme on QoL in people with HAND who were receiving ART. TRIAL DESIGN This was a parallel-group, randomised controlled trial with concealed allocation and intention-to-treat analysis. METHODS We identified 73 participants diagnosed with HAND. Participants were sampled from an earlier study that examined the prevalence of HAND according to the Frascati criteria. Participants were randomised and allocated to an intervention of 12-weeks of aerobic exercise, comprising three 20-60 min sessions per week of moderate-intensity aerobic exercise using a cycle ergometer. The primary outcome was QoL, which was evaluated using the World Health Quality of Life Questionnaire (WHOQoL)-BREF. RESULTS Participants in the exercise (n = 39) and control (n = 35) groups had similar sociodemographic characteristics (p > 0.05). Following the 12-week aerobic exercise programme, participants in the exercise group had improved physical (p < 0.001), psychological (p = 0.008) and environmental (p = 0.001) domains of the QoL (p = 0.001) and overall QoL (p = 0.001) relative to the control group. Similarly, participants in the exercise group had lower depression scores than participants in the control group. Depression scores in the exercise group were still lower 3 months post-intervention (p = 0.007). Only the improvements in physical (p = 0.02) and psychological (p = 0.007) domains of QoL were sustained at 3 months post-intervention. CONCLUSIONS Aerobic exercise improves the QoL of people with HAND. To ensure sustained benefits, people with HAND may need to engage in long-term physical exercise. Trial registration The trial is registered with the PAN African Trial Registry (PACTR). Date: 01/09/2020, ID: PACTR202009483415745.
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Affiliation(s)
- Martins Nweke
- Department of Physiotherapy, School of Healthcare Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mshunqane Nombeko
- Department of Physiotherapy, School of Healthcare Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nalini Govender
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Aderonke O. Akinpelu
- Department of Physiotherapy, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Department of Medicine, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Nigeria
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Gomes-Neto M, Saquetto MB, Alves IG, Martinez BP, Vieira JPB, Brites C. Effects of Exercise Interventions on Aerobic Capacity and Health-Related Quality of Life in People Living With HIV/AIDS: Systematic Review and Network Meta-Analysis. Phys Ther 2021; 101:6166193. [PMID: 33704496 DOI: 10.1093/ptj/pzab092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/29/2020] [Accepted: 02/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Exercise is a recommended component of care for people living with HIV/AIDS; however, it is unclear which type of exercise is most effective. The purpose of this study was to investigate the relative effects of different types of exercise interventions on aerobic capacity measured by peak oxygen consumption (peak VO2) and health-related quality of life (HRQoL) in this population. METHODS For this systematic review and indirect-comparisons meta-analysis (network meta-analysis), different electronic databases were searched up to February 2020 for randomized controlled trials that evaluated the effects of different types of exercise interventions on peak VO2 and HRQoL of people living with HIV/AIDS. Mean differences, standardized mean difference (SMD), and 95% CI were calculated. Fixed- and random-effects Bayesian network meta-analysis were used to compare the relative effectiveness of the different exercise interventions. RESULTS Forty studies met the study criteria, reporting on a total of 1518 patients. When comparing the exercise interventions with usual care (control group) for the peak VO2 outcome, combined aerobic and resistance exercise was the highest ranked exercise intervention with an SMD of 4.2 (95% CI = 2.5 to 5.9), followed by aerobic exercise (SMD = 3.1; 95% CI = 1.4 to 5.1). Compared with aerobic exercise, resistance training, and yoga, combined aerobic and resistance exercise was the best exercise intervention to promote improvement on physical function, general health, mental health, and energy/vitality domains HRQoL. CONCLUSION The combined aerobic and resistance exercise was the highest ranked exercise intervention to improve peak VO2 and HRQoL. Combined aerobic and resistance exercise should be considered as a component of care for people living with HIV/AIDS.
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Affiliation(s)
- Mansueto Gomes-Neto
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Micheli Bernardone Saquetto
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Iura Gonzalez Alves
- Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Bruno Prata Martinez
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Departamento de Fisioterapia, Curso de Fisioterapia, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil.,Physiotherapy Research Group, Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - João Paulo B Vieira
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
| | - Carlos Brites
- Programa de Pós-graduação em Medicina e Saúde da Universidade Federal da Bahia (UFBA), Salvador, Bahia, Brazil
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Ferrari Silva B, Oliveira GHD, Ferraz Simões C, Vissoci JRN, Peres SB, Moraes SMFD. Effects of exercise modality and intensity on the CD4 count in people with HIV: a systematic review and meta-analysis. AIDS Care 2021; 34:163-172. [PMID: 33745404 DOI: 10.1080/09540121.2021.1902932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to assess the effect of training modality and exercise intensity on the modulation of lymphocytes CD4 count in people living with HIV (PLWH). A search for randomised controlled trials was performed using five databases (PubMed/Medline, Cochrane, LILACS, Scielo and CAPES). Meta-analyses of mean differences (MD) were conducted using a random-effects model to compare the effects of training modality and intensity on CD4 count. The CD4 count comparing physical training vs. control group (MD of CD4 was 54.58 cell/ml³ [CI 95% 15.58-93.59], p =< 0.01). In according to the subgroup analysis, only aerobic exercise has proved to have a significant effect on CD4 (MD 79.91 cell/ml³ [CI 95% 19.30-140.52], p =< 0.01). When exercise intensities were stratified, only intense training proved to have a significant effect on CD4 (MD 64.87 cell/ml³ [CI 95% 15.79-113.95], p =< 0.01). In meta-regression analysis showed that the aerobic training, as well, high the intensity training were predictors significant to the improvement of CD4 (p =< 0.01). Exercise training is an important strategy to assist in the treatment of PLWH. The aerobic training modality and the high intensity training were able to promote improve the modulation of CD4 count chronically in PLWH.
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Affiliation(s)
- Bruno Ferrari Silva
- Department of Physical Education (DEF), Center of Health Sciences (CCS), UEM, Maringa, Brazil
| | | | - Caroline Ferraz Simões
- Department of Physical Education (DEF), Center of Health Sciences (CCS), UEM, Maringa, Brazil
| | - João R Nickenig Vissoci
- Department of Physical Education (DEF), Center of Health Sciences (CCS), UEM, Maringa, Brazil
| | - Sidney Barnabé Peres
- Department of Physiological Sciences (DFS), State University of Maringa (UEM), Maringa, Brazil
| | - Solange M Franzoi de Moraes
- Department of Physical Education (DEF), Center of Health Sciences (CCS), UEM, Maringa, Brazil.,Department of Physiological Sciences (DFS), State University of Maringa (UEM), Maringa, Brazil
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7
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Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV: A Meta-analysis. J Assoc Nurses AIDS Care 2020; 30:186-205. [PMID: 30822291 DOI: 10.1097/jnc.0000000000000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD = 0.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.
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Montano M, Bhasin S, D'Aquila RT, Erlandson KM, Evans WJ, Funderburg NT, Justice A, Ndhlovu LC, Ojikutu B, Pahor M, Pahwa S, Ryan AS, Schrack J, Schultz MB, Sebastiani P, Sinclair DA, Tripp J, Walker B, Womack JA, Yung R, Reeves RK. Harvard HIV and Aging Workshop: Perspectives and Priorities from Claude D. Pepper Centers and Centers for AIDS Research. AIDS Res Hum Retroviruses 2019; 35:999-1012. [PMID: 31456412 DOI: 10.1089/aid.2019.0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
People aging with HIV (PAWH) infection experience greater impairments in physical and cognitive function, in addition to higher rates of peripheral comorbid conditions (e.g., renal failure, diabetes, bone fracture, hypertension, cardiovascular disease, polypharmacy, and multimorbidity). While multifactorial drivers, including HIV infection itself, antiretroviral therapy-related toxicities, disparities in care, and biobehavioral factors, likely contribute, there remains an overarching question as to what are the relevant age-related mechanisms and models that could inform interventions that promote health span and life span in PAWH? This workshop was convened to hear from experts on the biology of aging and HIV researchers studying PAWH to focus on advancing investigations at the interface of HIV and Aging. In this study, we summarize the discussions from the Harvard Center for AIDS Research and Boston Claude D. Pepper cosponsored workshop on HIV and Aging, which took place in October 2018.
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Affiliation(s)
- Monty Montano
- Boston Pepper OAIC, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Shalender Bhasin
- Boston Pepper OAIC, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - William J Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, California
| | - Nicholas T Funderburg
- Division of Medical Laboratory Science, School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio
| | - Amy Justice
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Lishomwa C Ndhlovu
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Bisola Ojikutu
- Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marco Pahor
- Institute on Aging, Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida
| | - Savita Pahwa
- Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Alice S Ryan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
- Baltimore Veterans Affairs Geriatric Research Education and Clinical Center and Research and Development Service, Baltimore, Maryland
| | - Jennifer Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Michael B Schultz
- Department of Genetics, Paul F. Glenn Labs for the Biology of Aging, Blavatnik Institute, Harvard Medical School, Boston, Massachusetts
| | - Paola Sebastiani
- Department of Biostatistics, Boston University, Boston, Massachusetts
| | - David A Sinclair
- Department of Genetics, Paul F. Glenn Labs for the Biology of Aging, Blavatnik Institute, Harvard Medical School, Boston, Massachusetts
| | - Julia Tripp
- Harvard University Center for AIDS Research, Cambridge, Massachusetts
| | - Bruce Walker
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts
| | - Julie A Womack
- VA Connecticut Healthcare System, West Haven, Connecticut
- Yale School of Nursing, West Haven, Connecticut
| | - Raymond Yung
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - R Keith Reeves
- Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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9
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Heissel A, Zech P, Rapp MA, Schuch FB, Lawrence JB, Kangas M, Heinzel S. Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis. J Psychosom Res 2019; 126:109823. [PMID: 31518734 DOI: 10.1016/j.jpsychores.2019.109823] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/30/2019] [Accepted: 08/31/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. METHOD A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (≥ 18 years of age). Ten studies were included (n = 479 participants, 49.67% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. RESULTS A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95%CI = [-2.42, -0.04], p = 0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95%CI = [-1.63, -0.30], p = 0.004), a frequency of ≥3 exercise sessions per week (SMD = -1.39, 95%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95%CI = [-2.46, -0.17], p = 0.02). CONCLUSION Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.
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Affiliation(s)
- Andreas Heissel
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany.
| | - Philipp Zech
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany
| | - Michael A Rapp
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany
| | - Felipe B Schuch
- Departamento de métodos e técnicas desportivas, Universidade Federal de Santa Maria, Brazil
| | - Jimmy B Lawrence
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany
| | - Maria Kangas
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Stephan Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Germany
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10
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Quiles NN, Piao L, Ortiz A. The effects of exercise on lipid profile and blood glucose levels in people living with HIV: A systematic review of randomized controlled trials. AIDS Care 2019; 32:882-889. [PMID: 31514520 DOI: 10.1080/09540121.2019.1665163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Exercise is commonly prescribed to improve lipid profile and glucose levels in people living with HIV (PLWH). This systematic review was performed in order to examine the effects of exercise interventions on lipid profile and glucose levels on PLWH. Randomized controlled trials (RCTs) investigating the effects of exercise on blood glucose, triglycerides (TG), total cholesterol (TC), HDL and LDL published up to November 2017 were reviewed. Two reviewers assessed inclusion and exclusion criteria, methodological quality and extracted the data. The PEDro scale was used to assess the quality of the included studies. Nine RCTs involving 638 PLWH met inclusion criteria. The median PEDro scale score was 5 out of 10. Three combined aerobic exercise + resistance exercise studies (AE+RE) showed improvements in blood glucose levels, one study showed improvements in HDL, one showed improvements in TG, and one showed improvements in TC. The AE only study reported improvements in HDL, while the RE only study reported improvements in TG, TC, HDL and LDL. Exercise can be effective for the improvement of some metabolic parameters, especially blood glucose and HDL. However, due to methodological issues, small number of studies and differences in exercise protocols, these findings should be interpreted with caution.
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Affiliation(s)
- Norberto N Quiles
- Department of Family Nutrition and Exercise Sciences, Queens College of the City University of New York, NY, USA
| | - Lin Piao
- Department of Family Nutrition and Exercise Sciences, Queens College of the City University of New York, NY, USA
| | - Alexis Ortiz
- Department of Physical Therapy, University of Texas, San Antonio, TX, USA
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Bello TK, Gericke GJ, Maclntyre UE, Becker P. A nutrition education programme improves quality of life but not anthropometric status of adults living with HIV in Abeokuta, Nigeria. Public Health Nutr 2019; 22:2290-2302. [PMID: 31084656 PMCID: PMC10260542 DOI: 10.1017/s1368980019000636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The focus of interventions for adults living with HIV (ALH) in Nigeria has been mostly on prevention and provision of antiretroviral therapy (ART) with little consideration to nutrition-related matters. Therefore, the present study aimed to improve the quality of life (QoL) and anthropometric status of ALH in Abeokuta, Nigeria. DESIGN A quasi-experimental design where 200 conveniently selected participants were stratified by gender and duration on ART. The intervention group (n 100) received the nutrition education programme (NEP) for 12 weeks. The control group received a brochure on nutrition guidelines for ALH. Socio-biographical information, QoL and anthropometric status were assessed using previously validated questionnaires and standard techniques at baseline, week 12 and week 24. Generalised least squares (GLS) regression analysis was used for group comparisons. Anthropometric status was summarised by gender. SETTING Two tertiary hospitals in Abeokuta, Nigeria. PARTICIPANTS ALH. RESULTS The NEP led to significant improvement in the physical functioning (week 12 and 24: P < 0·01), role limitation due to physical health (week 12: P = 0·01; week 24: P = 0·002) and pain (week 12: P = 0·01) constructs of the QoL of the intervention group compared with the control group. There was no significant difference (P = 0·07) between the mean weights of the two groups at baseline. CONCLUSIONS There was a significant improvement at week 12 and week 24 in the QoL of the intervention participants. The results indicated that a tailored NEP could make a positive contribution to the management of ALH.
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Affiliation(s)
- Temitope K Bello
- Department of Human Nutrition, University of Pretoria, Private Bag X323, Pretoria 0001, South Africa
| | - Gerda J Gericke
- Department of Human Nutrition, University of Pretoria, Private Bag X323, Pretoria 0001, South Africa
| | - Una E Maclntyre
- Department of Human Nutrition, University of Pretoria, Private Bag X323, Pretoria 0001, South Africa
| | - Piet Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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12
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Goulding D, Wilson MP, MaWhinney S, Jankowski CM, Erlandson KM. A supervised exercise intervention fails to improve depressive symptoms and quality of life among sedentary older adults with HIV infection. AIDS Care 2019; 32:714-721. [PMID: 31238710 DOI: 10.1080/09540121.2019.1634788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Older people living with HIV (PLWH) experience multimorbidity that can negatively impact quality of life (QoL). Exercise can improve physical function, but effects on QoL are not well understood. 32 PLWH and 37 controls aged 50-75 completed 12-weeks of moderate-intensity exercise, then were randomized to moderate or high-intensity for 12 additional weeks. Depressive symptoms (CES-D scores) were significantly greater and QOL (SF-36 mental and physical summary scores) significantly lower among PLWH at baseline (all p < 0.05). PLWH had significantly greater worsening in CES-D scores compared to controls (3.4 [0.7, 6.0]; p = 0.01) between 13and 24 weeks. Mental QoL changed minimally, with no significant difference in changes by serostatus between weeks 0 and 12 or weeks 13 and 24 (p ≤ 0.22). Changes in physical function summary scores were similar by serostatus between 0 and 12 weeks (1.5 [-1.6, 4.6], p = 0.35), but declined significantly more among PLWH between 13 and 24 weeks (-4.1 [-7.2,-1], p = 0.01). Exercise intensity had no significant effect on changes in CES-D or SF-36 summary scores; high-intensity exercise was associated with greater improvements in vitality/fatigue (4.1 [0.8, 7.3], p = 0.02), compared to moderate-intensity. Exercise initiation failed to improve depressive symptoms or QoL among PLWH. Additional interventions may be needed to maximize these patient-reported outcomes among older PLWH initiating an exercise program.
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Mabweazara SZ, Ley C, Leach LL. Physical activity, social support and socio-economic status amongst persons living with HIV and AIDS: a review. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2019; 17:203-212. [PMID: 30003848 DOI: 10.2989/16085906.2018.1475400] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical activity can be used for the effective and comprehensive management of HIV and AIDS. Social support and socio-economic status (SES) are two factors that shape physical activity behaviours. Individuals of low SES carry a disproportionate burden of the HIV and AIDS epidemic. In addition, limited resources constitute socio-ecological barriers predisposing such individuals to physical inactivity. The purpose of this narrative review is to examine the available literature on physical activity, social support and SES and to generate recommendations for designing and implementing physical activity interventions targeting people living with HIV and AIDS (PLWHA) of low SES. The review used literature from Google, Google Scholar and PubMed on physical activity of PLWHA, social support for physical activity, and SES and physical activity. Qualitative and quantitative studies in English were included from 1970 to 2016. The results show that social support plays a major role in promoting physical activity and counteracting the barriers to PA in PLWHA of low SES. The results on the role of social support and the influence of SES are integrated to help design appropriate physical activity interventions for PLWHA of low SES. Well-designed interventions should utilise social support and be contextualised for PLWHA of low SES, whose living conditions present multiple barriers to physical activity.
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Affiliation(s)
- Smart Z Mabweazara
- a Department of Sport Recreation and Exercise Science , University of the Western Cape , Bellville , South Africa
| | - Clemens Ley
- b Institute of Sport Science , University of Vienna , Vienna , Austria
| | - Lloyd L Leach
- a Department of Sport Recreation and Exercise Science , University of the Western Cape , Bellville , South Africa
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Montoya JL, Jankowski CM, O’Brien KK, Webel AR, Oursler KK, Henry BL, Moore DJ, Erlandson KM. Evidence-informed practical recommendations for increasing physical activity among persons living with HIV. AIDS 2019; 33:931-939. [PMID: 30946147 PMCID: PMC6457127 DOI: 10.1097/qad.0000000000002137] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Jessica L. Montoya
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Catherine M. Jankowski
- University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, Colorado, USA
| | - Kelly K. O’Brien
- Department of Physical Therapy; Rehabilitation Sciences Institute; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Allison R. Webel
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Krisann K. Oursler
- Geriatric Research and Education, Salem Veterans Medical Center, Salem, Virginia, USA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Brook L. Henry
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - David J. Moore
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Kristine M. Erlandson
- Division of Infectious Diseases; Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, Colorado, USA
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15
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Ibeneme SC, Irem FO, Iloanusi NI, Ezuma AD, Ezenwankwo FE, Okere PC, Nnamani AO, Ezeofor SN, Dim NR, Fortwengel G. Impact of physical exercises on immune function, bone mineral density, and quality of life in people living with HIV/AIDS: a systematic review with meta-analysis. BMC Infect Dis 2019; 19:340. [PMID: 31014262 PMCID: PMC6480814 DOI: 10.1186/s12879-019-3916-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 03/18/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Compromised immune function, associated with human immune deficiency virus(HIV) infection, is improved by antiretroviral therapy(ART) which also decreases bone mineral density(BMD), and possibly the quality of life(QoL). However, physical(aerobic/resistance) exercises, were reported to induce reverse effects in uninfected individuals and were appraised in the literature for evidence of similar benefits in people living with HIV/AIDS(PLWHA). The main study objective was to evaluate the impact of physical (aerobic and resistance) exercises on CD4+ count, BMD and QoL in PLWHA. METHODS A systematic review was conducted using the Cochrane Collaboration protocol. Searching databases, up to June 2017, only randomized control trials investigating the effects of either aerobic, resistance or a combination of both exercise types with a control/other intervention(s) for a period of at least 4 weeks among adults living with HIV, were included. Two independent reviewers determined the eligibility of the studies. Data were extracted and risk of bias(ROB) was assessed with the Cochrane Collaboration ROB tool. Meta-analyses were conducted using random effect models using the Review Manager(RevMan) computer software. RESULTS Nineteen studies met inclusion criteria(n = 491 participants at study completion) comprising male and female with age range 22-66 years. Two meta-analyses across 13 sub-group comparisons were performed. However, there were no RCTs on the impact of physical exercises on BMD in PLWHA. The result showed no significant change in CD4+ count unlike a significant effect of 5.04 point(95%CI:-8.49,-3.74,p = 0.00001) for role activity limitation due to physical health(QoL sub-domain). Overall, the GRADE evidence for this review was of moderate quality. CONCLUSIONS There was evidence that engaging in moderate intensity aerobic exercises (55-85% Maximum heart rate-MHR), for 30-60 min, two to five times/week for 6-24 weeks significantly improves role activity limitation due to physical health problems, otherwise physical(aerobic or/and resistance) exercises have no significant effects on CD4+ count and other domains of QoL. Also, there is lack of evidence on the impact of exercises on BMD in PLWHA due to the paucity of RCTs. The moderate grade evidence for this review suggests that further research may likely have an important impact on our confidence in the estimate of effects and may change the estimate.
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Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
| | - Franklin Onyedinma Irem
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Nneka Ifeyinwa Iloanusi
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
| | - Amarachi Destiny Ezuma
- Exercise Immunology/Palliative care unit, Department of Physiotherapy, University of Nigeria, Teaching Hospital, Ituku/Ozalla, Enugu State, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
| | - Fortune Elochukwu Ezenwankwo
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Philip Chinedu Okere
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
| | - Amaka Obiageli Nnamani
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
| | - Salome Nwaelom Ezeofor
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
| | - Ngozi Regina Dim
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
- Clinical Trial Consortium University of Nigeria, Nsukka, Nigeria
| | - Gerhard Fortwengel
- Fakultaat III, Hochschhule Hannover University of Applied Sciences & Arts, Expo Plaza 12, 30539 Hannover, Germany
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa
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John DO, Tella BA, Olawale OA, John JN, Adeyemo TA, Okezue OC. Effects of a 6-week aerobic exercise programme on the cardiovascular parameters, body composition, and quality of life of people living with human immune virus. J Exerc Rehabil 2018; 14:891-898. [PMID: 30443538 PMCID: PMC6222150 DOI: 10.12965/jer.1836306.153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/12/2018] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the effects of aerobic exercise program on the cardiovascular parameters, body composition, and quality of life (QoL) of people living with human immune virus (HIV). Patients were recruited from the HIV clinic in a tertiary hospital in Nigeria. Fish bowl method was used to randomize the patients to either experimental or control group. Experimental group received nutritional counseling and aerobic exercise program on a treadmill, 3 times a week for a period of 6 weeks, while the control group received only nutritional counseling. Cardiovascular parameters, aerobic fitness, body composition parameters, and QoL were evaluated at baseline and 6 weeks. Descriptive statistics was used to explore demographic data while the hypothesis was tested using inferential statistics of t-test. Alpha level was set at P<0.05. The result showed that there was an improvement in cardiovascular parameters in both groups, attaining significance in the experimental group (P=0.000). Aerobic fitness increased significantly in experimental group (P=0.000). Body composition decreased significantly while there was a significant difference in the muscle mass (%) between groups (P<0.05). All domains of QoL had a significant improvement in both groups (P<0.005). A 6-week aerobic exercise program in addition to nutritional counseling was able to significantly improve cardiovascular fitness, body composition, and QoL in people living with HIV/acquired immune deficiency syndrome. Nutritional counseling alone can bring about an improvement only in QoL parameters.
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Affiliation(s)
| | - Bosede A Tella
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olajide A Olawale
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Jeneviv N John
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
| | - Titilope A Adeyemo
- Department of Haematology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Obinna C Okezue
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Nsukka, Nigeria
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Voigt N, Cho H, Schnall R. Supervised Physical Activity and Improved Functional Capacity among Adults Living with HIV: A Systematic Review. J Assoc Nurses AIDS Care 2018; 29:667-680. [PMID: 29861318 DOI: 10.1016/j.jana.2018.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 05/04/2018] [Indexed: 12/18/2022]
Abstract
Physical activity (PA) combats the effects of multimorbidity and antiretroviral therapy in people living with HIV (PLWH), but PLWH often don't meet recommended PA guidelines. The purpose of our review was to investigate whether supervised PA improved functional capacity in PLWH. Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Five databases were searched for randomized controlled trials in English, with participants ages 18 years and older, and a supervised PA intervention. A database search yielded 8,267 articles, with 15 eligible for review inclusion. We found a low risk of bias within and across studies. Combined aerobic/progressive resistance training (PRT) improved strength, cardiovascular, and flexibility outcomes; aerobic interventions alone showed no significant improvements; PRT improved strength outcomes; yoga or yoga/meditation showed no outcome differences; and t'ai chi showed cardiovascular and flexibility improvements. We found that supervised PA increased functional capacity in PLWH and that self-report was not a reliable assessment.
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18
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Nosrat S, Whitworth JW, Ciccolo JT. Exercise and mental health of people living with HIV: A systematic review. Chronic Illn 2017; 13:299-319. [PMID: 29119865 DOI: 10.1177/1742395317694224] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective Mental illness is highly prevalent among people living with HIV. Poor mental health is linked to HIV disease progression, making the treatment of mental illness alongside HIV essential. While the benefits of exercise on the physical health of people living with HIV are well established, the effect of exercise on mental health in this population is less examined. Therefore, this study aimed to conduct a systematic literature review of the effects of exercise on mental health in people living with HIV. Methods A search of electronic databases (PubMed, Web of Science, PsycINFO) through 30 November 2016 was completed. The methodological framework for scoping studies was used to conduct the review process. RISMA guidelines were used to report the results. Results The search resulted in 2273 articles and 52 were determined to be relevant. After review of the full text of potentially relevant studies, 24 studies were included for the analysis. Discussion Both aerobic and resistance exercise have independent and combined positive effects on various indicators of mental health in people living with HIV. Major limitations include high attrition rate, small sample size, and poor study designs. Higher quality studies with more diverse populations such as women, older adults, and transgender individuals are required.
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Affiliation(s)
- Sanaz Nosrat
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - James W Whitworth
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
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Bhatta DN, Liabsuetrakul T, McNeil EB. Social and behavioral interventions for improving quality of life of HIV infected people receiving antiretroviral therapy: a systematic review and meta-analysis. Health Qual Life Outcomes 2017; 15:80. [PMID: 28438211 PMCID: PMC5404320 DOI: 10.1186/s12955-017-0662-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 04/21/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Improvement in quality of life is crucial for HIV infected people. Social and behavioral interventions have been implemented in different contexts to improve the quality of life among HIV infected people. This review appraises the evidence for available interventions that focused on quality of life of HIV infected people receiving antiretroviral therapy (ART). METHODS We searched electronic databases for randomized controlled trials of interventions to improve the quality of life of HIV infected people receiving ART. We searched PUBMED and the Cochrane Centre Register of Controlled Trials (CENTRAL) with the terms "social", "behavioral", "educational", "quality of life", "HIV", and "RCT". Searches were conducted for articles published from 1980 to December 16, 2015. Standardized data abstraction methods and searching steps were applied. RESULTS Twenty-eight studies reported the impact of social or behavioral interventions in quality of life among HIV infected people, of which 15 were conducted in United States of America. A total of 4136 participants were enrolled. Of the 28 studies, four studies included females, two studies included males and remaining studies excluded both males and females. The overall reported methodological quality of the studies was subject to a high risk of bias and the study criteria were unclear in most studies. Twenty-one studies reported a significant intervention effect on at least one quality of life domain. Meta-analyses showed significant improvement in general health, mental health, physical function and environment domains of quality of life among intervention groups. However, the expected impact of the intervention was low to moderate because the rigorousness of the studies was low, information was limited, the sample sizes were small and other the quality of the study designs were poor. CONCLUSIONS Although the available evidence suggests that existing social and behavioral interventions can improve some quality of life domains, the quality of evidence was insufficient to support the notion that these interventions can improve the overall quality of life of HIV infected people receiving ART. Well-designed and rigorous randomized controlled trials with high methodological quality are required.
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Affiliation(s)
- Dharma Nand Bhatta
- Department of Community Medicine and Public Health, Tribhuvan University, Peoples’ Dental College, Kathmandu, Nepal
- Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Hat Yai, Thailand
- Department of Public Health, Pokhara University, Nobel College, Kathmandu, Nepal
| | | | - Edward B. McNeil
- Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Hat Yai, Thailand
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Effectiveness of Progressive Resistive Exercise (PRE) in the context of HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis 2017; 17:268. [PMID: 28403830 PMCID: PMC5389006 DOI: 10.1186/s12879-017-2342-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 03/25/2017] [Indexed: 11/10/2022] Open
Abstract
Background HIV is increasingly considered a chronic illness. More individuals are living longer and aging with the health-related consequences associated with HIV and multi-morbidity. Exercise is a self-management approach that can promote health for people aging with HIV. We examined the safety and effectiveness of progressive resistive exercise (PRE) interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV. Methods We conducted a systematic review using the Cochrane Collaboration protocol. Searching databases up to April 2013, we included randomized controlled trials that compared PRE with no exercise or another intervention performed at least three times per week for at least four weeks with adults living with HIV. Two reviewers independently determined study eligibility. We extracted data from included studies and assessed risk of bias using the Cochrane Collaboration risk of bias tool. Meta-analyses were conducted using random effects models with Review Manager (RevMan) computer software. Results Twenty studies met inclusion criteria (n = 764 participants at study completion); the majority of participants were men (77%) taking antiretroviral therapy (14/20 included studies). Exercise interventions included PRE alone (8 studies) or a combination of resistive and aerobic exercise (12 studies) ranging from 6 to 52 weeks in duration. Thirty-four meta-analyses were performed. Results demonstrated statistically significant improvements in cardiorespiratory status (maximum oxygen consumption, exercise time), strength (chest press, knee flexion), weight, and body composition (arm and thigh girth, leg muscle area) among exercisers versus non-exercisers. We found no significant differences in change in CD4 count and viral load. We were unable to perform meta-analyses for psychological outcomes however results from individual studies demonstrated improvements in health-related quality of life with exercisers compared with non-exercisers. Conclusions Performing progressive resistive exercise (PRE) or a combination of resistive and aerobic exercise at least three times per week for at least six weeks is safe and can lead to improvements in cardiorespiratory fitness, strength, weight, and body composition for adults with HIV. Exercise may be considered a safe and beneficial for enhancing the health of medically stable adults aging with HIV. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2342-8) contains supplementary material, which is available to authorized users.
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Papagianni M, Tziomalos K. Obesity in patients with HIV infection: epidemiology, consequences and treatment options. Expert Rev Endocrinol Metab 2016; 11:395-402. [PMID: 30058909 DOI: 10.1080/17446651.2016.1220297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Even though wasting used to characterize patients with HIV infection prior to the antiretroviral therapy (ART) era, obesity is becoming increasingly prevalent in this population. Areas covered: In the present review, we discuss the epidemiology, consequences and treatment options for obesity in patients with HIV infection. Expert commentary: Obesity exerts a multitude of detrimental cardiometabolic effects and appears to contribute to the increasing cardiovascular mortality of this population. However, there are very limited data on the optimal management of obesity in patients with HIV infection. Given the potential for interactions between antiobesity agents and ART that might compromise viral control, lifestyle changes should represent the cornerstone for the prevention and management of obesity in HIV infection.
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Affiliation(s)
- Marianthi Papagianni
- a First Propedeutic Department of Internal Medicine, Medical School , Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
| | - Konstantinos Tziomalos
- a First Propedeutic Department of Internal Medicine, Medical School , Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
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d’Ettorre G, Ceccarelli G, Pavone P, Vittozzi P, De Girolamo G, Schietroma I, Serafino S, Giustini N, Vullo V. What happens to cardiovascular system behind the undetectable level of HIV viremia? AIDS Res Ther 2016; 13:21. [PMID: 27127532 PMCID: PMC4848790 DOI: 10.1186/s12981-016-0105-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/14/2016] [Indexed: 11/08/2022] Open
Abstract
Despite the combined antiretroviral therapy has improved the length and quality of life of HIV infected patients, the survival of these patients is always decreased compared with the general population. This is the consequence of non-infectious illnesses including cardio vascular diseases. In fact large studies have indicated an increased risk of coronary atherosclerotic disease, myocardial infarction even in HIV patients on cART. In HIV infected patients several factors may contribute to the pathogenesis of cardiovascular problems: life-style, metabolic parameters, genetic predisposition, viral factors, immune activation, chronic inflammation and side effects of antiretroviral therapy. The same factors may also contribute to complicate the clinical management of these patients. Therefore, treatment of these non-infectious illnesses in HIV infected population is an emerging challenge for physicians. The purpose of this review is to focus on the new insights in non AIDS-related cardiovascular diseases in patients with suppressed HIV viremia.
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O'Brien KK, Tynan AM, Nixon SA, Glazier RH. Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis 2016; 16:182. [PMID: 27112335 PMCID: PMC4845358 DOI: 10.1186/s12879-016-1478-2] [Citation(s) in RCA: 145] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 03/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with HIV are living longer with the health-related consequences of HIV, multi-morbidity, and aging. Exercise is a key strategy that may improve or sustain health for people living with HIV. Our aim was to examine the safety and effectiveness of aerobic exercise interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV. METHODS We conducted a systematic review using the Cochrane Collaboration protocol. We searched databases up to April 2013. We included randomized controlled trials comparing aerobic exercise with no exercise or another intervention performed at least three times per week for at least four weeks among adults living with HIV. Two reviewers independently determined study eligibility. Data were extracted from studies that met inclusion criteria using standardized forms. We assessed risk of bias using the Cochrane Collaboration's tool for assessing risk of bias. Outcomes were analyzed as continuous and meta-analyses conducted using random effects models with Review Manager (RevMan) computer software. RESULTS Twenty-four studies met inclusion criteria (n = 936 participants at study completion); the majority of participants were men (73 %) and the majority were taking antiretroviral therapy (19/24 included studies). The exercise intervention included aerobic exercise alone (11 studies) or a combination of aerobic and resistive exercise (13 studies) ranging from 5 to 52 weeks. Fifty-eight meta-analyses were performed. Main results indicated statistically significant improvements in selected outcomes of cardiorespiratory status (maximum oxygen consumption, exercise time), strength (chest press, knee flexion), body composition (lean body mass, percent body fat, leg muscle area), depression symptoms, and quality of life (SF-36 questionnaire) among exercisers compared with non-exercisers. No significant differences in change in CD4 count and viral load were found. CONCLUSIONS Performing aerobic exercise or a combination of aerobic and resistive exercise at least three times per week for at least five weeks is safe and can lead to improvements in cardiorespiratory fitness, strength, body composition and quality of life for adults with HIV. Aerobic exercise is safe and beneficial for adults living with HIV who are medically stable.
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Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada. .,Rehabilitation Sciences Institute (RSI), University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada. .,Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.
| | - Anne-Marie Tynan
- Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Stephanie A Nixon
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada.,Rehabilitation Sciences Institute (RSI), University of Toronto, 500 University Avenue, Room 160, Toronto, ON, Canada
| | - Richard H Glazier
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.,Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, G1 06 2075 Bayview Ave, Toronto, ON, Canada.,Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, ON, Canada
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Gomes Neto M, Conceição CS, Carvalho VO, Brites C. Effects of Combined Aerobic and Resistance Exercise on Exercise Capacity, Muscle Strength and Quality of Life in HIV-Infected Patients: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0138066. [PMID: 26378794 PMCID: PMC4574781 DOI: 10.1371/journal.pone.0138066] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 08/25/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Many HIV-infected patients demonstrate disability and lower aerobic capacity. The inclusion of resistance training combined with aerobic exercise in a single program is known as combined aerobic and resistance exercise (CARE) and seems to be an effective strategy to improve muscle weakness, as well as aerobic capacity in HIV-infected patients. We performed a meta-analysis to investigate the effects of CARE in HIV-infected patients. METHODS We searched MEDLINE, Cochrane Controlled Trials Register, EMBASE, CINAHL (from the earliest date available to august 2014) for controlled trials that evaluated the effects of CARE in HIV-infected patients. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I2 test. RESULTS Seven studies met the study criteria. CARE resulted in improvement in Peak VO2 WMD (4.48 mL·kg-1·min-1 95% CI: 2.95 to 6.0), muscle strength of the knee extensors WMD (25.06 Kg 95% CI: 10.46 to 39.66) and elbow flexors WMD (4.44 Kg 95% CI: 1.22 to 7.67) compared with no exercise group. The meta-analyses also showed significant improvement in Health status, Energy/Vitality and physical function domains of quality of life for participants in the CARE group compared with no exercise group. A nonsignificant improvement in social function domain of quality of life was found for participants in the CARE group compared with no exercise group. CONCLUSIONS Combined aerobic and resistance exercise may improve peak VO2, muscle strength and health status, energy and physical function domains of quality of life and should be considered as a component of care of HIV-infected individuals.
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Affiliation(s)
- Mansueto Gomes Neto
- Departamento de Biofunçāo, Curso de Fisioterapia da Universidade Federal da Bahia, UFBA, Salvador, BA, Brazil
- Programa de Pós Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil
- The GREAT Group (GRupo de Estudos em ATividade física), Universidade Federal de Sergipe, Aracaju, SE, Brazil
| | - Cristiano Sena Conceição
- Departamento de Biofunçāo, Curso de Fisioterapia da Universidade Federal da Bahia, UFBA, Salvador, BA, Brazil
| | - Vitor Oliveira Carvalho
- The GREAT Group (GRupo de Estudos em ATividade física), Universidade Federal de Sergipe, Aracaju, SE, Brazil
- Departamento de Fisioterapia da Universidade Federal de Sergipe, UFS, Aracaju, SE, Brazil
| | - Carlos Brites
- Programa de Pós Graduação em Medicina e Saúde, UFBA, Salvador, BA, Brazil
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d'Ettorre G, Ceccarelli G, Giustini N, Mastroianni CM, Silvestri G, Vullo V. Taming HIV-related inflammation with physical activity: a matter of timing. AIDS Res Hum Retroviruses 2014; 30:936-44. [PMID: 25055246 DOI: 10.1089/aid.2014.0069] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many sets of data indicate that HIV-infected individuals maintain a low level of chronic immune activation and inflammation even in the presence of effective antiretroviral therapy (ART). This residual immune activation seems to be associated with accelerated aging and an increased incidence of non-AIDS-defining illnesses. Several published studies suggest that physical activity is a beneficial nonpharmacological intervention to reduce chronic inflammation. However, currently available data on the potential benefits of regular physical exercises for HIV-infected individuals are limited. Nonetheless, increasing evidence suggests that the introduction of regular physical exercise in the clinical management of HIV-infected individuals may have a significant positive impact in reducing some of the long-term complications of both infection and ART. Based on a comprehensive review of the existing data, we propose that regular physical exercise should be further studied as a potential antiinflammatory, nonpharmacological approach to be used to treat HIV residual disease and non-AIDS-defining illnesses in ART-treated HIV-infected individuals.
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Affiliation(s)
- Gabriella d'Ettorre
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci Bolognetti, University of Rome “Sapienza,” Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci Bolognetti, University of Rome “Sapienza,” Rome, Italy
| | - Noemi Giustini
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci Bolognetti, University of Rome “Sapienza,” Rome, Italy
| | - Claudio M. Mastroianni
- Department of Infectious Diseases, Istituto Pasteur-Fondazione Cenci Bolognetti, University of Rome “Sapienza,” Polo Pontino, Italy
| | - Guido Silvestri
- Department of Pathology, Emory University School of Medicine and Yerkes National Primate Research Center, Atlanta, Georgia
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Istituto Pasteur-Fondazione Cenci Bolognetti, University of Rome “Sapienza,” Rome, Italy
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Physical activity and health outcomes among HIV-infected men who have sex with men: a longitudinal mediational analysis. Ann Behav Med 2014; 46:149-56. [PMID: 23483379 DOI: 10.1007/s12160-013-9489-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Low physical activity is associated with depression, which may, in turn, negatively impact antiretroviral therapy (ART) adherence among HIV-infected individuals; however, prior studies have not investigated the relationships between physical inactivity and ART non-adherence. PURPOSE The purpose of this study was to examine the association of physical inactivity, depression, ART non-adherence, and viral load in HIV-infected men who have sex with men. METHODS The sample (N = 860) was from a large, multicenter cohort of HIV-infected patients engaged in clinical care. RESULTS Across time, depression mediated the relationship between physical inactivity and ART non-adherence (γ = 0.075) and the relationship between physical inactivity and viral load (γ = 0.05). ART non-adherence mediated the relationship between depression and viral load (γ = 0.002) and the relationship between physical inactivity and viral load (γ = 0.009). CONCLUSIONS Low levels of physical activity predicted increased depression and poor ART adherence over time, which subsequently predicted higher viral load.
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Towards integrated multiple behavior management for HIV and chronic conditions: a comment on Blashill et al. Ann Behav Med 2014; 46:131-2. [PMID: 23616178 DOI: 10.1007/s12160-013-9506-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Alves MD, Brites C, Sprinz E. HIV-associated lipodystrophy: a review from a Brazilian perspective. Ther Clin Risk Manag 2014; 10:559-66. [PMID: 25083134 PMCID: PMC4108257 DOI: 10.2147/tcrm.s35075] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The prognosis of human immunodeficiency virus (HIV)-infected individuals has dramatically improved worldwide since the introduction of highly antiretroviral therapy. Nevertheless, along with the decrease in mortality, several body modifications not initially related to HIV infection have been reported. Disorders in lipid and glucose metabolism, accompanied by body shape abnormalities and alterations in fat distribution, began to be described. A syndrome, named "HIV-associated lipodystrophy syndrome", was coined to classify these clinical spectrum aspects. This syndrome involves not only metabolic alterations but also fat redistribution, with lipoatrophy due to subcutaneous fat loss (predominantly in the face and lower limbs) and lipohypertrophy related to central fat gain. These changes in body shape are very important to be recognized, as they are associated with worse morbidity and mortality. Self-esteem difficulties related to body alterations might lead to treatment failures due to medication adherence problems. Moreover, these alterations have been associated with an increased risk of cardiovascular events. Therefore, it is extremely important to identify this syndrome early in order to provide an even better quality of life for this population, as the clinical approach is not easy. Treatment change, medications to treat dyslipidemia, and surgical intervention are instruments to be used to try to correct these abnormalities. The aim of this study is to review clinical presentation, diagnosis, and management of body shape and metabolic complications of HIV infection from a Brazilian perspective, a medium income country with a large number of patients on antiretroviral therapy.
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Affiliation(s)
- Marcelle D Alves
- Infectious Disease Department, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
| | - Carlos Brites
- School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Eduardo Sprinz
- Infectious Disease Department, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil
- School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Zhu H, Yuan J, Wei C, Chen J, Wang Y. Evaluation of right ventricular function by Doppler tissue imaging of the tricuspid annulus in patients with acquired immune deficiency syndrome. Exp Ther Med 2014; 7:747-749. [PMID: 24520280 PMCID: PMC3919889 DOI: 10.3892/etm.2014.1480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 12/23/2013] [Indexed: 01/14/2023] Open
Abstract
Chronic heart disease contributes to the mortality of patients with AIDS. Although studies of left ventricular function in patients with acquired immune deficiency syndrome (AIDS) have been conducted, studies of right ventricular function are rare. The present study aimed to characterize the tricuspid annulus movement and evaluate the right ventricular function of patients with AIDS by tissue Doppler imaging. Tissue Doppler echocardiography was performed on 106 patients with AIDS and 64 controls. Tricuspid annulus movements were detected from the apical four-chamber view and the apical right heart two-chamber view. The peak diastolic early period velocity (Ve), peak diastolic later period velocity (Va) and peak systolic velocity (Vs) were measured at the anterior, posterior and lateral walls and also at the interventricular septum. Mean values were calculated, as well as the Tei index of the lateral site. Compared with the values in the control group, the Vs and Va of the AIDS group decreased at all sites with the exception of the lateral wall, whereas the Ve decreased at all sites of the tricuspid annulus (P<0.05). The Tei index was higher in the AIDS group than in the control (P<0.05). The results obtained in the present study show that the function of the right ventricle decreases in patients with AIDS, which is indicative of susceptibility to right ventricular dysfunction.
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Affiliation(s)
- Haohui Zhu
- Department of Ultrasound Diagnostics, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China
| | - Jianjun Yuan
- Department of Ultrasound Diagnostics, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China
| | - Changhua Wei
- Department of Ultrasound Diagnostics, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China
| | - Jiyun Chen
- Department of Ultrasound Diagnostics, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China
| | - Yisa Wang
- Department of Ultrasound Diagnostics, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, P.R. China
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Della Justina LB, Luiz MC, Maurici R, Schuelter-Trevisol F. Prevalence and factors associated with lipodystrophy in AIDS patients. Rev Soc Bras Med Trop 2014; 47:30-7. [DOI: 10.1590/0037-8682-0240-2013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 01/28/2014] [Indexed: 12/13/2022] Open
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Botros D, Somarriba G, Neri D, Miller TL. Interventions to address chronic disease and HIV: strategies to promote exercise and nutrition among HIV-infected individuals. Curr HIV/AIDS Rep 2013; 9:351-63. [PMID: 22933247 DOI: 10.1007/s11904-012-0135-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Food insecurity, micronutrient deficits, dyslipidemia, insulin resistance, obesity, cardiovascular disease, and bone disorders complicate the treatment of HIV infection. Nutrition and exercise interventions can be effective in ameliorating these symptoms that are associated with HIV and antiretroviral therapy (ART). In this literature review, we examine the most recent nutrition and exercise interventions for HIV-infected patients. Macronutrient supplementation can be useful in treating malnutrition and wasting. Multivitamin (vitamin B complex, vitamin C, and vitamin E) supplements and vitamin D may improve quality of life and decrease morbidity and mortality. Nutritional counseling and exercise interventions are effective for treating obesity, fat redistribution, and metabolic abnormalities. Physical activity interventions improve body composition, strength, and fitness in HIV-infected individuals. Taken collectively, the evidence suggests that a proactive approach to nutrition and physical activity guidance and interventions can improve outcomes and help abrogate the adverse metabolic, cardiovascular, and psychological consequences of HIV and its treatments.
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Affiliation(s)
- Diana Botros
- Division of Pediatric Clinical Research, Department of Pediatrics (D820), University of Miami, Miller School of Medicine, Batchelor Children's Research Institute, PO Box 016820, Miami, FL 33101, USA.
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Somarriba G, Lopez-Mitnik G, Ludwig DA, Neri D, Schaefer N, Lipshultz SE, Scott GB, Miller TL. Physical fitness in children infected with the human immunodeficiency virus: associations with highly active antiretroviral therapy. AIDS Res Hum Retroviruses 2013; 29:112-20. [PMID: 22747252 PMCID: PMC3537323 DOI: 10.1089/aid.2012.0047] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Obesity, sedentary lifestyles, and antiretroviral therapies may predispose HIV-infected children to poor physical fitness. Estimated peak oxygen consumption (VO(2) peak), maximal strength and endurance, and flexibility were measured in HIV-infected and uninfected children. Among HIV-infected children, anthropometric and HIV disease-specific factors were evaluated to determine their association with VO(2) peak. Forty-five HIV-infected children (mean age 16.1 years) and 36 uninfected children (mean age 13.5 years) participated in the study. In HIV-infected subjects, median viral load was 980 copies/ml (IQR 200-11,000 copies/ml), CD4% was 28% (IQR 15-35%), and 82% were on highly active antiretroviral therapy (HAART). Compared to uninfected children, after adjusting for age, sex, race, body fat, and siblingship, HIV-infected children had lower VO(2) peak (25.92 vs. 30.90 ml/kg/min, p<0.0001), flexibility (23.71% vs. 46.09%, p=0.0003), and lower-extremity strength-to-weight ratio (0.79 vs. 1.10 kg lifted/kg of body weight, p=0.002). Among the HIV-infected children, a multivariable analysis adjusting for age, sex, race, percent body fat, and viral load showed VO(2) peak was 0.30 ml/kg/min lower per unit increase in percent body fat (p<0.0001) and VO(2) peak (SE) decreased 29.45 (± 1 .62), 28.70 (± 1.87), and 24.09 (± 0.75) ml/kg/min across HAART exposure categories of no exposure, <60, and ≥ 60 months, respectively (p<0.0001). HIV-infected children had, in general, lower measures of fitness compared to uninfected children. Factors negatively associated with VO(2) peak in HIV-infected children include higher body fat and duration of HAART ≥ 60 months. Future studies that elucidate the understanding of these differences and mechanisms of decreased physical fitness should be pursued.
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Affiliation(s)
- Gabriel Somarriba
- Divisions of Pediatric Clinical Research, University of Miami, Miami, Florida
| | | | - David A. Ludwig
- Divisions of Pediatric Clinical Research, University of Miami, Miami, Florida
| | - Daniela Neri
- Divisions of Pediatric Clinical Research, University of Miami, Miami, Florida
- Pediatric Infectious Diseases, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Natasha Schaefer
- Divisions of Pediatric Clinical Research, University of Miami, Miami, Florida
| | - Steven E. Lipshultz
- Divisions of Pediatric Clinical Research, University of Miami, Miami, Florida
| | - Gwendolyn B. Scott
- Pediatric Infectious Diseases, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida
| | - Tracie L. Miller
- Divisions of Pediatric Clinical Research, University of Miami, Miami, Florida
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De Lorenzo A, Meirelles V, Vilela F, Souza FCC. Use of the exercise treadmill test for the assessment of cardiac risk markers in adults infected with HIV. J Int Assoc Provid AIDS Care 2012; 12:110-6. [PMID: 23015380 DOI: 10.1177/1545109712460098] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite the association between HIV and coronary artery disease (CAD), there are no specific recommendations for the cardiovascular evaluation of the HIV-infected population. Besides being a tool for the evaluation of CAD, the exercise treadmill test (ETT) provides insights into functional capacity and autonomic function, which have been frequently affected in HIV infection, and thus may be useful in this setting. METHODS Forty-nine HIV-infected individuals without known CAD underwent ETT. Peak oxygen consumption during exercise (VO2 peak), functional capacity (in metabolic equivalents [METs]), exercise-induced ischemia, chronotropic incompetence (CI) and abnormal heart rate recovery (HRR) after exercise were studied. RESULTS VO2 peak was 31.4±4.8 mL/kg/min and functional capacity was 9.2±1.6 MET. CI was observed in 30.6%, and 10.2% had abnormal HRR. VO2 peak was lower in women and inversely correlated with age and body mass index. None of the patients displayed ischemic changes. CONCLUSION Although functional capacity was good, risk markers such as CI and abnormal HRR were not infrequent. This study identifies a subgroup of HIV-infected patients-the older, overweight, or obese-who may have higher risk and deserve cardiovascular screening with the ETT.
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