Effects of physical exercises on inflammatory biomarkers and cardiopulmonary function in patients living with HIV: a systematic review with meta-analysis

Abstract

Background Pro-inflammatory cytokines expressed in human immune deficiency virus (HIV) infection, may induce oxidative stress likely to compromise the patency of the airways or damage the lung tissues/cardiac function. However, physical (aerobic and/or resistance) exercise-induced release of heat shock protein, immune function alteration or reduced tissue hypoxia, have been highlighted as possible mechanisms by which increasing physical activity may reduce plasma pro-inflammatory cytokines in uninfected individuals and should be appraised in the literature for evidence of similar benefits in people living with HIV (PLWH). Therefore, we evaluated the effects of physical exercises on 1) inflammatory biomarkers and 2) cardiopulmonary function (VO 2 Max) in PLWH. Method A systematic review was conducted using the Cochrane Collaboration protocol. Searching databases, up to January 2018. Only randomized control trials investigating the effects of either aerobic or resistance or a combination of both exercise types with a control/other intervention(s) for a period of at least 4 weeks among adults living with HIV, were included. Two independent reviewers determined the eligibility of the studies. Data were extracted and risk of bias (ROB) was assessed with the Cochrane Collaboration ROB tool. Meta-analyses were conducted with random effect models using the Review Manager (RevMan) computer software. Result Twenty-three studies met inclusion criteria ( n = 1073 participants at study completion) comprising male and female with age range 18–65 years. Three meta-analyses across three sub-groups comparisons were performed. The result showed no significant change in biomarkers of inflammation (IL-6 and IL-1β) unlike a significant (Z = 3.80, p < 0.0001) improvement in VO 2 Max. Overall, the GRADE evidence for this review was of moderate quality. Conclusion There was evidence that engaging in either aerobic or resistance exercise, or a combination of both exercises, two to five times per week can lead to a significant improvement in cardiopulmonary function but not biomarkers of inflammation (IL-6 and IL-1β). However, this should not be interpreted as “No evidence of effect” because the individual trial studies did not attain sufficient power to detect treatment effects. The moderate grade evidence for this review suggests that further research may likely have an important impact on our confidence in the estimate of effects and may change the estimate. Electronic supplementary material The online version of this article (10.1186/s12879-019-3960-0) contains supplementary material, which is available to authorized users.

Effect of Structured Physical Activity on Inflammation and Immune Activation Profile of Antiretroviral Therapy-Experienced Children Living With HIV

“…We observed a significant reduction in the levels of TNF-α among the exercisers compared with the nonexercisers in this study. However, the IL-6 levels did not differ significantly which is similar to the findings from other studies that showed no significant impact of exercise training on IL-6 levels (20). It has been observed that although ART itself reduces the levels of IL-6, IFN-γ, and IL-10 to the levels seen in uninfected controls, a similar effect is not observed in the case of TNF-α and the levels of which remain elevated even after prolonged ART (3,34,37).…”

Effectiveness of mobile text reminder in improving adherence to medication, physical exercise, and quality of life in patients living with HIV: a systematic review

“…The lack of reliable evidence to guide practice in this regard is an important gap in the literature because physical exercise has been found to minimize or improve co-morbidities associated with HIV/AIDS. Physical exercises improve cardiovascular fitness, muscle strength, lean body mass, instability of fat metabolism, increase bone mineral density, reduce risk of fracture and invariably enhance the quality of life in people living with HIV/AIDS [ 33 , 34 ].…”

Examining the impact of a community-based exercise intervention on cardiorespiratory fitness, cardiovascular health, strength, flexibility and physical activity among adults living with HIV: A three-phased intervention study

“…Exercise can reduce the risk of multimorbidity and improve health outcomes for adults living with HIV [9][10][11]. Systematic review evidence demonstrated that engaging in aerobic, resistive or combined aerobic and resistive exercise at least three times per week can improve cardiorespiratory fitness, strength and quality of life outcomes among adults living with HIV [12][13][14].…”