Effects of a Supervised Exercise Program on Immunologic Function

Abstract

Background. Exercise has known benefits in persons living with HIV (PLWH). Several studies have shown acute improvement in the immunologic function of PLWH in supervised exercise programs. The purpose of this study is to show changes in CD4 count following a 24-week group exercise program and 6 months post study period. Methods. Overweight and obese (mean body mass index [BMI] 32 ± 6.5) adults recruited in an inner city HIV clinic participated in instructor-led group exercise for 60 minutes 2-3 times a week for 24 weeks at low to moderate intensity. Participants received standard clinical care consisting of routine follow-up with their primary care provider (PCP). Inclusion criteria were being obese or overweight (BMI > 25 kg/m2) with type 2 diabetes (36%), hypertension (61%), hyperlipidemia (47%) and/or depression (36%). Pregnant women, those who were not medically cleared by their provider or with active psychosis were excluded. Paired t-test was used in data analysis of CD4 count and percentage. Results. Participants (N = 36) were 83% black (53% African American and 30% African descent/immigrants), 14% Hispanic, and 3% white; 56% females, 44% males; mean age was 53.5 ± 9.5 years, with median CD4 of 692 ± 373 cells at pre-exer-cise; 67% were HIV virally suppressed. 97% were on long-term antiretroviral therapy (ART), 50% on protease inhibitor-based ART. Participant mean CD4 count dropped to 621 ± 289 post exercise (P = 0.04) and was lower compared with that of controls (655 ± 339, P = 0.19) but rebounded to 655 ± 341 (P = 0.27) 6 months post study. Participant CD4% significantly improved 6 months post study to 31 ± 9 from 29± 9 post exercise (P < 0.005) with no significant difference compared to control. Conclusion. Despite a significant decrease in the CD4 count in the post-exercise period, there was an up-trend observed 6 months after the program ended. HIV providers should be aware of this transient immunologic reduction and still recommend structured exercise programs, as benefits have been shown to improve weight, metabolic parameters and psychological well-being of PLWH.