Physical activity and exercise to improve cardiovascular health for adults living with HIV

Prog Cardiovasc Dis. 2020 Mar-Apr;63(2):178-183. doi: 10.1016/j.pcad.2020.01.005. Epub 2020 Jan 31.

Abstract

Pharmacologic advancements in the treatment of human immunodeficiency virus (HIV) has extended the life expectancy of people living with HIV (PLWH). An unfortunate side effect of HIV treatment, however, is an increased prevalence of dyslipidemia, glycemic dysregulation and abnormal distribution of body fat (lipodystrophy). Consequently, the risk of developing cardiovascular disease (CVD) is significantly increased in PLWH and ultimately a major cause of mortality. Physical activity and exercise training are interventions that have effectively protected against the development of CVD and, in the presence of CVD, has help mitigate morbidity and mortality. Early concerns over potential immunosuppressive effects of exercise in PLWH have largely been dispelled and in some cases exercise has been shown to strengthen markers of immune function. Interventions with aerobic exercise, resistance exercise, and their combination, particularly at higher intensities, are showing promising health outcomes in PLWH. This review will summarize the key cardiovascular and metabolic effects of antiretroviral therapy; the effects of the types and intensities of exercise on cardiorespiratory fitness, cardiometabolic markers, and muscle strength; and provide recommendations on strategies to apply exercise interventions in clinical settings.

Keywords: Cardiovascular disease; Exercise; HIV; Physical activity.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / adverse effects
  • Anti-HIV Agents / therapeutic use*
  • Cardiorespiratory Fitness
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • Exercise*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Long-Term Survivors*
  • Health Status
  • Humans
  • Life Expectancy
  • Preventive Health Services*
  • Prognosis
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • Sedentary Behavior
  • Viral Load

Substances

  • Anti-HIV Agents