Beneficial effects of physical activity in an HIV-infected woman with lipodystrophy: a case report

The Acute Effect of a Single Resistance Training Session on the Glycemic Response among Women with HIV/AIDS

The purpose of this study was to investigate the effect of a single resistance training session on the glycemic and lipid response of women with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) treated with Antiretroviral Therapy (ART). The sample consisted of 10 female subjects who underwent one resistance training session involving different muscle groups, that is, three sets of 8-12 repetitions with an interval of 90 seconds between the sets, and 120 seconds between exercises. The loads used in each exercise corresponded to an intensity equivalent to the interval of 5-7, which was in accordance with the OMNI-RES scale. The capillary glycemic levels were evaluated under the fed state before (Pre) and immediately after (Post) the exercise session. In order to evaluate the total cholesterol, HDL, and triglycerides (TG), blood samples were collected before (Pre) and one hour after the experimental protocol (Post). Non-HDL values were obtained using the Friedewald formula. The results showed that after a single resistance training session, alterations occurred in the glycemic response (p = 0.03), with a decrease of 11.4% in the values when comparing Pre and Post workout moments (99.8 ± 14.3 mg/dL vs. 87.3 ± 11.3 mg/dL, respectively). However, no significant result was observed regarding lipid response. In conclusion, a single resistance training session can reduce glycemic response in HIV positive people treated with ART without interfering with the lipid response.

Physical activity among HIV-positive patients receiving antiretroviral therapy in Hanoi and Nam Dinh, Vietnam: a cross-sectional study

OBJECTIVES

Antiretroviral therapy (ART) has facilitated the transition of HIV infection into a chronic disease, where adherence to medications is required along with keeping a healthy lifestyle. Therefore, an increase in physical activity has been recommended for patients with HIV in order to maintain their health status. This study looked to determine the physical activity level and its associated factors among patients with HIV receiving ART treatment.

SETTINGS

Eight outpatient clinic sites across different levels of the health systems in both rural and urban settings in Hanoi and Nam Dinh, Vietnam.

STUDY DESIGN AND PARTICIPANTS

A cross-sectional study was performed among 1133 patients with HIV receiving ART treatment from January to August 2013.

PRIMARY AND SECONDARY OUTCOME MEASURES

Physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). Socioeconomic, health-related quality of life, ART adherence and ART-related characteristics were self-reported.

RESULTS

16% of participants were inactive, and 68% were reported active via health-enhancing physical activity. Rural participants reported a higher level of physical activity compared with urban participants. Participants having a longer duration of ART were less likely to be physically active. Participants who were female and self-employed, who had higher CD4 cell count, higherEuroQol - 5 dimensions - 5levels (EQ-5D-5L) index/EQ-Visual Analogue Scale, and shared their health status with their peers were more likely to have a higher IPAQ score or be physically active. A lower IPAQ score was associated with participants living in urban areas and being at the symptomatic stage. Participants having poor adherence and longer duration of ART were more likely to be physically inactive.

CONCLUSION

The majority of participants who received ART were physically active. There is a need for interventions to promote physical activity among patients with HIV in urban areas and in the later ART treatment phases. Other potential interventions to increase the level of physical activity include peer support and job guidance.

Dietary Patterns and Physical Activity Correlate With Total Cholesterol Independently of Lipid-Lowering Drugs and Antiretroviral Therapy in Aging People Living With Human Immunodeficiency Virus

Background

Hypercholesterolemia is a well established risk factor for coronary heart disease and is highly prevalent among human immunodeficiency virus (HIV)-positive persons. Antiretroviral therapy (ART) can both directly modify total cholesterol and have drug-drug interactions with statins. This makes investigating modifiable behavioral predictors of total cholesterol a pertinent task.

Methods

To explore the association between diet and physical activity with cross-sectionally measured total cholesterol, we administered a validated Food-Frequency-Questionnaire to participants of the Swiss HIV Cohort Study ≥45 years old. Linear mixed-effects models were applied to explore the associations between dietary patterns and physical activity with total cholesterol, after adjustment for clinical and demographic covariates.

Results

In total, 395 patients were included. Forty percent (158 of 395) had elevated total cholesterol (>5.2 mmol/L), and 41% (164 of 395) were not regularly physically active. In multivariable analysis, 2 factors were positively associated with total cholesterol; female sex (β = 0.562; 95% confidence interval [CI], 0.229–0.896) and the combined consumption of meat, refined/milled grains, carbonated beverages, and coffee (β = 0.243; 95% CI, 0.047–0.439). On the other hand, regular physical activity (β = −0.381; 95% CI, −0.626 to −0.136), lipid-lowering drugs (β = −0.443; 95% CI −0.691 to −0.196), ART containing tenofovir (β = −0.336; 95% CI −0.554 to −0.118), and black ethnicity (β = −0.967; 95% CI −1.524 to −0.410) exhibited a negative association.

Conclusions

We found independent associations between certain dietary patterns and physical activity with total cholesterol. Increasing physical activity might achieve cardiovascular and other health benefits in HIV-positive individuals. The clinical relevance of the identified dietary patterns requires further investigation in prospective cohort studies and randomized controlled trials.

RESPOSTAS AGUDAS DO EXERCÍCIO FÍSICO EM PESSOAS INFECTADAS PELO HIV: UMA REVISÃO SISTEMÁTICA

RESUMO O treinamento físico é uma estratégia importante para a saúde de pessoas que vivem com HIV/AIDS; contudo, suas respostas a curto prazo ainda não foram amplamente estudadas, o que limita o entendimento dos efeitos e da segurança da prescrição do treinamento para essa população. Portanto, objetivou-se revisar sistematicamente as respostas agudas decorrentes do exercício físico em pessoas com HIV sobre variáveis fisiológicas e imunológicas. Para isso, foi realizada uma revisão sistemática a partir de trabalhos indexados nas seguintes bases de dados: Medline, Lilacs, Scielo, Web of Science e Science Direct. Os descritores utilizados foram: acquired immunodeficiency syndrome, HIV, AIDS, seropositive, acute session, short, physical activity, exercise, training. As buscas foram realizadas em fevereiro de 2015 e atualizadas em dezembro de 2015 e foram conduzidas sem restrição de datas de publicação ou idioma específico. Foram incluídos para esta revisão artigos que avaliaram as respostas agudas decorrentes de algum modelo de prescrição de treinamento físico envolvendo exercícios aeróbicos, com pesos ou combinados (exercícios aeróbicos e com pesos) relacionados com variáveis fisiológicas e imunológicas em pessoas infectadas pelo HIV. Foram encontrados 2.422 títulos, dos quais, após exclusão das duplicatas e a aplicação dos critérios de elegibilidade, foram selecionados sete artigos para síntese qualitativa. De acordo com os resultados reportados pelos estudos há evidências de que, imediatamente após a realização do exercício físico, ocorre um aumento do número de células circulantes, incluindo leucócitos totais, neutrófilos, monócitos e linfócitos T CD8+ em pessoas infectadas pelo HIV. Além disso, também se observaram alterações significantes nas concentrações de lactato, triglicerídeos, epinefrina e norepinefrina imediatamente após a realização do treinamento aeróbico, independentemente do uso de TARV e/ou de hiperlactatemia. No entanto, não há evidências suficientes para afirmar que o treinamento físico seja totalmente seguro e eficaz para esta população.

Toward a systemic research agenda for addressing the joint epidemics of HIV/AIDS and noncommunicable diseases

A growing proportion of people living with HIV/AIDS also struggle to cope with one or several noncommunicable diseases (NCDs), particularly as they age. The two epidemics being intertwined, there is increasing recognition that that there should be closer advocacy, policy and programmatic links between HIV and NCDs. The objective of this paper is to discuss the development of a research agenda geared towards informing the design and implementation of programs and policies truly grounded in a co-benefits approach. Tackling the joint epidemics of HIV/AIDS and NCDs in Africa will require for research funders and private and foreign aid donors to be bold, visionary and to commit to long-term research investments in order to evaluate the effects of natural policy experiments and complex interventions.