Abstract 19576: Impaired Fitness is Common in Adults Living With HIV, Despite Viral Suppression, and Correlates With Markers of Immune Dysregulation

Abstract

Introduction: Since transitioning to a chronic health condition, treated HIV infection is now recognized as an independent risk factor for cardiovascular disease. The underlying reasons for this risk association are unclear, but may include poor cardiopulmonary fitness. Objective: To describe cardiopulmonary fitness in people living with HIV (PLHIV) and its association to lifestyle exercise and HIV characteristics. Methods: As part of a larger randomized clinical trial, we conducted a cross sectional analysis of 37 PLHIV at high risk for developing CVD, on HIV medications, with suppressed HIV viremia. All subjects completed a bicycle cardiopulmonary stress test using a ramp protocol, wore an accelerometer on their hip for seven days, and consented to medical chart abstraction. We summarize the exercise habits and baseline cardiopulmonary fitness of our population, and further analyzed associations between continuous variables using Spearman correlation coefficients. Results: Overall, the study population had poor cardiopulmonary fitness (Table 1). Subjects exercised on average twice in the past week, but mostly (85%) light activity. Current CD4+ T cell count was significantly associated with VO2 max, peak heart rate, and % peak heart rate (Table 2). As expected, fitness variables were also associated in a graded fashion with time spent exercising in light, moderate, and moderate-vigorous activity. Conclusions: Current CD4+ T cell count and lifestyle exercise are significantly and consistently associated with cardiopulmonary fitness. Further work is necessary to understand how these relationships change over time and in response to interventions.