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Mabweazara SZ, Manne-Goehler J, Hamer M, Cellini J, Siedner MJ. Characteristics and efficacy of physical activity interventions to improve cardiometabolic and psychosocial outcomes in people living with HIV in sub-Saharan Africa: a protocol for a systematic review. Syst Rev 2023; 12:24. [PMID: 36814348 PMCID: PMC9948386 DOI: 10.1186/s13643-023-02186-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Antiretroviral therapy (ART) has led to an increased lifespan for people living with HIV (PWH). This increased lifespan, coupled with the effects of HIV and adverse effects of ART have resulted in an increasing burden of cardiometabolic disease (CMD) among PWH. Physical activity (PA) has been proposed as an effective strategy to reduce the risk of developing cardiometabolic disease and other health complications in PWH. The aim of this paper is to review the characteristics and efficacy of PA interventions to improve cardiometabolic and psychosocial outcomes among PWH in sub-Saharan Africa. METHODS The review will follow the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). Literature searches will be conducted in PubMed, Web of Science (WoS), African Index Medicus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase. Peer-reviewed publications will be included if they include adults (age 18 or older), PWH in sub-Saharan Africa, and a PA intervention to improve cardiometabolic outcomes and/or psychosocial outcomes. We will include randomized controlled trials and quasi-experimental study designs. Two independent reviewers will screen all abstracts and full-text articles. The study methodological quality (or bias) will be appraised using the Revised tool to assess risk of bias in randomized trials and the Downs and Black checklist. Certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation guidelines. Meta-analyses will be conducted if our results are adequate for meta-analysis. Outcomes will be analyzed as continuous or dichotomous and meta-analyses will be conducted using random effects models with Stata computer software. DISCUSSION This review will identify and synthesize the current evidence regarding the characteristics and efficacy of PA interventions to improve cardiometabolic and psychosocial outcomes among PWH in sub-Saharan Africa. We also plan to identify the strengths and weaknesses of evaluated interventions. Based on the evidence, recommendations will be made to promote the design and further evaluate the most promising strategies to maximize the efficacy of PA interventions in improving cardiometabolic and psychosocial outcomes in PWH in sub-Saharan Africa. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration ID: CRD42021271937.
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Affiliation(s)
- SZ Mabweazara
- Africa Health Research Institute, Africa Centre Building, Route 618, Somkhele, KwaZulu Natal South Africa
| | - J Manne-Goehler
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | - M Hamer
- University College London, London, UK
| | | | - MJ Siedner
- Africa Health Research Institute, Africa Centre Building, Route 618, Somkhele, KwaZulu Natal South Africa
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, USA
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Barros JP, de Paula T, Mediano MFF, Rangel MVDS, Monteiro W, da Cunha FA, Farinatti P, Borges JP. The Effects of Acute Aerobic Exercise on Blood Pressure, Arterial Function, and Heart Rate Variability in Men Living With HIV. Front Physiol 2021; 12:685306. [PMID: 34335295 PMCID: PMC8320391 DOI: 10.3389/fphys.2021.685306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study aims to investigate the effects of acute cycling on blood pressure (BP), arterial function, and heart rate variability (HRV) in men living with HIV (MLHIV) using combined antiretroviral therapy (cART). METHODS Twelve MLHIV (48.7 ± 9.2 years; 25.2 ± 2.8 kg m-2) and 13 healthy controls (41.2 ± 9.9 years; 26.3 ± 2.9 kg m-2) performed a cycling bout (ES) (intensity: 50% oxygen uptake reserve; duration: time to achieve 150 kcal-MLHIV: 24.1 ± 5.5 vs. controls: 23.1 ± 3.0 min; p = 0.45), and a 20-min non-exercise session (NES). RESULTS At rest (p < 0.05), MLHIV presented higher brachial systolic/diastolic BP (SBP/DBP: 123.2 ± 14.2/76.8 ± 6.3 vs. 114.3 ± 5.1/71.6 ± 2.6 mmHg) and central BP (cSBP/cDBP: 108.3 ± 9.3/76.5 ± 6.5 vs. 101.6 ± 4.9/71.3 ± 4.4 mmHg) vs. controls but lower absolute maximal oxygen uptake (2.1 ± 0.5 vs. 2.5 ± 0.3 L min-1) and HRV indices reflecting overall/vagal modulation (SDNN: 24.8 ± 7.1 vs. 42.9 ± 21.3 ms; rMSSD: 20.5 ± 8.5 vs. 38.1 ± 22.8 ms; pNN50: 3.6 ± 4.2 vs. 13.6 ± 11.3%). DBP postexercise lowered in controls vs. MLHIV (∼4 mmHg, p < 0.001; ES: 0.6). Moreover, controls vs. MLHIV had greater reductions (p < 0.05) in augmentation index (-13.6 ± 13.7 vs. -3.1 ± 7.2% min-1; ES: 2.4), and HRV indices up to 5 min (rMSSD: -111.8 ± 32.1 vs. -75.9 ± 22.2 ms min-1; ES: 3.8; pNN50: -76.3 ± 28.3 vs. -19.0 ± 13.7% min-1; ES: 4.4). Within-group (ES vs. NES; p < 0.05) reductions occurred in controls for SBP (∼10 mmHg, 2 h), DBP (∼6 mmHg, 20, 30, and 70 min), cSBP (∼9 mmHg, 30 min), cDBP (∼7 mmHg, 30 and 70 min), augmentation index (∼10%, 30 min), and pNN50 (∼20%; up to 2 h), while in MLHIV only cSBP (∼6 mmHg, 70 min) and cDBP (∼4 mmHg, 30 min) decreased. Similar increases (up to 5 min) in heart rate (∼22 bpm) and decreases in SDNN (∼18 ms) and rMSSD (∼20 ms) occurred in both groups. CONCLUSION MLHIV under cART exhibited attenuated postexercise hypotension vs. healthy controls, which seemed to relate with impairments in vascular function.
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Affiliation(s)
- Juliana Pereira Barros
- Graduate Program in Exercise and Sports Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Tainah de Paula
- Department of Clinical Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Mauro Felippe Felix Mediano
- Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Department of Research and Education, National Institute of Cardiology, Ministry of Health, Rio de Janeiro, Brazil
| | | | - Walace Monteiro
- Graduate Program in Exercise and Sports Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, Brazil
| | - Felipe Amorim da Cunha
- Graduate Program in Exercise and Sports Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Paulo Farinatti
- Graduate Program in Exercise and Sports Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, Niteroi, Brazil
| | - Juliana Pereira Borges
- Graduate Program in Exercise and Sports Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Zanetti HR, Mendes EL, Gonçalves A, Lopes LT, Roever L, Silva-Vergara ML, Neves FF, Resende ES. Effects of exercise training and statin on hemodynamic, biochemical, inflammatory and immune profile of people living with HIV: a randomized, double-blind, placebo-controlled trial. J Sports Med Phys Fitness 2021; 60:1275-1282. [PMID: 33124791 DOI: 10.23736/s0022-4707.20.10838-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the effect of exercise training (ET) and statins on the hemodynamic, biochemical, inflammatory and immune profile of people living with HIV (PLHIV). METHODS This was a randomized, double-blind, placebo-controlled clinical trial in which 83 PLHIV were assigned to either placebo (PL), statins (STA), placebo + ET (PLET), or statins + ET (STAET) groups. Volunteers assigned to STA and STAET groups were administered 10 mg of rosuvastatin, whereas the PL and PLET groups were administered a placebo. The PLET and STAET groups performed ET three times a week. Before and after the 12-week follow-up, volunteers underwent blood collection to assess the biochemical, inflammatory, and immune profile. RESULTS There were significant time x group interaction effects (P<0.05) for all variables except for diastolic blood pressure. The PLET and STAET groups had significantly (P<0.05) decreased systolic blood pressure, resting heart rate, fasting glucose, glycated hemoglobin, fasting insulin, homeostatic model assessment for insulin resistance, creatine kinase, lactate, and TNF-α levels, and increased adiponectin, CD4<sup>+</sup>, and CD8<sup>+</sup> levels. There was also a significant group effect (P<0.05) for CK levels among the exercised (PLET and STAET) and STA groups. The latter had a significant increase in fasting glucose (P<0.05) and creatine kinase (P<0.05). CONCLUSIONS ET improved the hemodynamic, biochemical, inflammatory, and immune profile of PLHIV and this effect was not dependent on the use of statins.
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Affiliation(s)
| | - Edmar L Mendes
- Federal University of Triângulo Mineiro, Uberaba, Brazil
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Yakasai AM, Maharaj SS. Does moderate intensity aerobic and progressive resisted exercise affect cardiovascular product in persons living with HIV-related distal symmetrical poly-neuropathy? GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020. [DOI: 10.23736/s0393-3660.20.04100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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de Souza DC, Domingues WJ, Marchini KB, Nunhes PM, Garcia A, Hey LF, Ardengue M, Pasinato I, Avelar A. Acute effect of resistance exercise on cognitive function in people living with HIV. Int J STD AIDS 2020; 32:59-66. [PMID: 33070698 DOI: 10.1177/0956462420958578] [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: 11/15/2022]
Abstract
People living with HIV are at an increased risk of developing cognitive deficits. Physical exercise is an important strategy to improve the brain health of people living with HIV. This randomized, controlled study aimed to investigate the acute effect of a single resistance exercise session on the cognitive function of people living with HIV. Twenty-three people living with HIV were randomized (1:1) to a control group (n = 12) or the exercise group (n = 11). Cognitive function was assessed by the Stroop test and the Trail Making Test. The exercise group was evaluated before and after the exercise session; meanwhile, the control group was evaluated before and after a 40-minute rest period. No statistical difference was found on the effect of exercise on cognitive function (p > 0.05). This result suggests that one session of resistance exercise was not capable of improving the cognitive function of people with HIV.
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Affiliation(s)
- Dayane C de Souza
- Department of Physical Education, Western State University of Parana, Marechal Cândido Rondon, Brazil
| | - Wagner Jr Domingues
- Collegiate of Physical Education, Institute of Social Sciences, Education and Zootechnics, Federal University of Amazonas, Parintins, Brazil
| | - Kauana B Marchini
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Pollyana M Nunhes
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | | | - Lucas F Hey
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Mariana Ardengue
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Isabela Pasinato
- Department of Physical Education, State University of Maringa, Maringa, Brazil
| | - Ademar Avelar
- Department of Physical Education, State University of Maringa, Maringa, Brazil
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Souza DC, Nunhes PM, Domingues WJR, Marchini K, Hey L, Berti JA, Trindade MCC, Avelar A. The Acute Effect of a Single Resistance Training Session on the Glycemic Response among Women with HIV/AIDS. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:319-328. [PMID: 32148620 PMCID: PMC7039483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
- Dayane C Souza
- Department of Physical Education, State University of Maringa, Maringa, PR, BRAZIL
| | - Pollyana M Nunhes
- Department of Physical Education, State University of Maringa, Maringa, PR, BRAZIL
| | - Wagner J R Domingues
- Collegiate of Physical Education, Institute of Social Sciences, Education and Zootechnics, Federal University of Amazonas, Parintins, AM, BRAZIL
| | - Kauana Marchini
- Department of Physical Education, State University of Maringa, Maringa, PR, BRAZIL
| | - Lucas Hey
- Department of Physical Education, State University of Maringa, Maringa, PR, BRAZIL
| | - Jairo A Berti
- Department of Physiology, State University of Maringa, Maringa, PR, BRAZIL
| | - Michele C C Trindade
- Department of Physical Education, State University of Maringa, Maringa, PR, BRAZIL
| | - Ademar Avelar
- Department of Physical Education, State University of Maringa, Maringa, PR, BRAZIL
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Ozemek C, Erlandson KM, Jankowski CM. Physical activity and exercise to improve cardiovascular health for adults living with HIV. Prog Cardiovasc Dis 2020; 63:178-183. [PMID: 32014512 DOI: 10.1016/j.pcad.2020.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 01/29/2020] [Indexed: 12/11/2022]
Abstract
Pharmacologic advancements in the treatment of human immunodeficiency virus (HIV) has extended the life expectancy of people living with HIV (PLWH). An unfortunate side effect of HIV treatment, however, is an increased prevalence of dyslipidemia, glycemic dysregulation and abnormal distribution of body fat (lipodystrophy). Consequently, the risk of developing cardiovascular disease (CVD) is significantly increased in PLWH and ultimately a major cause of mortality. Physical activity and exercise training are interventions that have effectively protected against the development of CVD and, in the presence of CVD, has help mitigate morbidity and mortality. Early concerns over potential immunosuppressive effects of exercise in PLWH have largely been dispelled and in some cases exercise has been shown to strengthen markers of immune function. Interventions with aerobic exercise, resistance exercise, and their combination, particularly at higher intensities, are showing promising health outcomes in PLWH. This review will summarize the key cardiovascular and metabolic effects of antiretroviral therapy; the effects of the types and intensities of exercise on cardiorespiratory fitness, cardiometabolic markers, and muscle strength; and provide recommendations on strategies to apply exercise interventions in clinical settings.
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Affiliation(s)
- Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Kristine M Erlandson
- School of Medicine, Division of Infectious Diseases, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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