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EFFECTS OF HIV STATUS ON FUNCTIONAL BENEFITS OF EXERCISE IN OLDER SEDENTARY ADULTS
Kristine M. Erlandson1, Samantha MaWhinney1, Melissa P. Wilson1, Lilyana Gross1, Sean A. McCandless1, Wendy M. Kohrt1, Robert Schwartz1, Todd T. Brown2, Thomas Campbell1, Catherine M. Jankowski1
1University of Colorado Anschutz Medical Campus, Aurora, CO, USA,2Johns Hopkins Hospital, Baltimore, MD, USA
Whether older, sedentary HIV+ adults can achieve similar functional benefits with exercise as their HIV- peers and the ideal intensity of exercise needed for these benefits is not known.
Older (50-75 years of age) sedentary HIV+ (undetectable HIV-1 RNA on antiretroviral therapy for ≥ 2 years) and HIV- participants were recruited for a 24 wk supervised, 3x/week cardiovascular and resistance exercise program. Participants exercised at moderate intensity for 0-12 wks, then were randomized to moderate (50% V02 maximum [V02max], 60-70% 1-repetition maximum [RM]) or high intensity (70% V02max, ≥80% 1-RM) exercise for an additional 12 wks. 10x chair rise time and 1-RM were measured every 3 wks; V02max and 400-m walk time at wk 0, 12, and 24. Outcomes by serostatus and exercise intensity were compared using linear and mixed effects regression models and adjusted for baseline values (for wk 0-12) or wk 12 (for 12-24 wk change).
28 HIV+ and 31 HIV- participants completed 12 wks; 27 HIV+ (12 moderate/15 high) and 30 HIV- (14 moderate/16 high) completed 24 wks of exercise. HIV+ participants were thinner (BMI 27 vs 30 kg/m2), younger (57 vs 60 years), less likely never smokers (39 vs 58%), and had more comorbidities (79 vs 55% with ≥3) compared to HIV-. Among HIV+ participants the CD4+ T-cell was 564 (467,682) cells/mm3, and mean time since HIV diagnosis was 20 (17,23) yrs. At week 0, HIV+ participants had faster 400-m walk time but slower 10x chair rise (Table) compared to HIV- participants. Both groups had significant improvements in all physical function measures except V02max from 12-24 wks in HIV+ for moderate intensity (Table). HIV+ participants had significantly greater improvements than HIV- on V02 max between wk 0-12 (5 [0,10]% greater; p=0.04) and in 400-m walk between weeks 12-24 (-3 [-5,0]% faster; p=0.03). An interaction between exercise intensity and HIV serostatus was significant only on 1-RM measures: HIV+/high-intensity exercisers gained significantly more strength than HIV+/moderate exercises in bench press (6 [0, 12]% greater) and leg press (10 [2, 17]% greater; both p<0.05); HIV- had similar gains regardless of intensity.
Exercise training reverses physical function impairment to a similar extent in older, sedentary HIV+ and HIV- adults. HIV+ persons randomized to high intensity exercise showed greater gains in strength than HIV- persons, which may suggest an added benefit of high intensity exercise among older sedentary HIV+ adults.