Effect Of A Community-Based Exercise Program On Inflammation And Fitness Among Persons Living With HIV/AIDS

Abstract

The Human Immunodeficiency Virus (HIV) pandemic remains a top national health priority. Chronic inflammation may be a critical component in the disease course of HIV as C-reactive protein (CRP) is elevated and associated with increased mortality. PURPOSE: To examine the effect of three months of combined aerobic and resistance exercise training on inflammation and metabolic risk among a diverse cohort of HIV-infected men and women. METHODS: Ninety male and female participants were enrolled in the Healthy Living for Better Days community-based exercise program for persons living with HIV/AIDS. All participants were encouraged to attend supervised exercise sessions held four times a week, but also given open access to the fitness center at the University of Miami. High sensitivity CRP, physical fitness, and metabolic risk factors were assessed for each participant at baseline and three months. Linear Mixed Modeling was used to assess the fixed effect of time on changes in the outcome variables from baseline to three months follow up. Paired t-tests were used to assess changes in metabolic risk factors. RESULTS: Fifty-five percent of total participants were non-compliant with the prescribed exercise, though nearly one-quarter of participants were meeting physical activity recommendations after three months. Mean levels of CRP were elevated at baseline (5.75 ± 0.82 mg/L). The fixed effect of time for CRP was found to be non-significant (F[1,57.3]=1.7, p=0.19). There was a significant fixed effect for time for upper body (F[1,51.6]=18.1, p<0.05) and lower body strength (F[1,48.0]=15.7, p<0.05) and significant declines in diastolic blood pressure (p=0.002) and waist circumference (p=0.027). CONCLUSION: Though levels of CRP were not impacted after three months training, participants demonstrated a significant increase in muscular strength as well as beneficial changes in metabolic risk factors. Low compliance to the prescribed exercise limited our ability to make definitive conclusions about the impact of exercise on systemic inflammation. Future studies should focus on effective ways of engaging and retaining HIV-infected minorities in structured exercise interventions and discerning the optimal dose and duration of exercise to reduce inflammation.