Abstract
OBJECTIVES:Comprehensive care for people living with human immunodeficiency virus (HIV) (PLH) includes the promotion of healthier habits, including physical activity (PA). This study aimed to describe a multicomponent pragmatic trial protocol to assess the effect of PA in preventing body changes and metabolic disturbances, improving the quality of life of PLH starting antiretroviral therapy (ART) and present cohort characteristics.METHODS:PLH undergoing ART for ≤4 months were recruited for a randomized trial. The intervention comprised three cardiorespiratory and/or strength training sessions per week at the clinic or in public spaces for 6 months under on-site or remote supervision, and educational sessions. Participants’ PA levels, cardiorespiratory fitness, anthropometric measures, strength, flexibility, quality of life, and laboratory monitoring (blood glucose and lipids, CD4 counts) at baseline and post-intervention will be compared. The pragmatic design aims to enable the assessment of intervention effectiveness in real-life conditions.RESULTS:At baseline, our cohort of 38 recently diagnosed patients (mean time since HIV diagnosis and duration of ART were 3 and 2.58 months, respectively) were predominantly male, young, with high schooling and good immune status (median CD4 count=498 cells/mm3). Twenty-two (57.9%) patients reported a PA below the World Health Organization recommendations. We found baseline normal anthropometric measures and metabolic parameters: below-average trunk flexion and elbow extension strength, poor handgrip strength and flexibility, and high quality of life scores in all except the physical domain.CONCLUSIONS:Understanding how effective PA is in preventing body changes and metabolic disturbances, and in improving the quality of PLH starting ART may help establish guidelines to better incorporate PA in HIV care.
Highlights
Combined antiretroviral therapy (ART) has resulted in remarkable changes in the human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) pandemic, by reducing the HIV-related morbidity and mortality globally and contributing to decreased viral transmission [1]
Metabolic disturbances associated with HIV infection and ART
Previous intervention studies have addressed the impact of physical activity (PA) in people living with HIV (PLH), including those who already presented with body changes or metabolic disturbances [11,12,13]
Summary
Combined antiretroviral therapy (ART) has resulted in remarkable changes in the human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) pandemic, by reducing the HIV-related morbidity and mortality globally and contributing to decreased viral transmission [1]. In this context, with a significant reduction in the incidence of opportunistic infections and increased survival of PLH, specialized services are faced with novel healthcare needs associated with chronic HIV infection, including lipodystrophy (body changes and metabolic disturbances) and various organ dysfunctions (cardiovascular, kidney, bone, and/or liver) that significantly impair patients’ quality of life [3]
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