Journal Article

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

Nnamani, Amaka Obiageli, Ezeofor, Salome Nwaelom, Anieto, E. M., Ibeneme, G. C., Irem, F., Ibeneme, S. C., Omeje, C., Ezenwankwo, Fortune Elochukwu, Myezwa, H.

2019

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acquired immune deficiency syndrome / Aerobic exercises / AIDS / Antiretroviral agents / Antiretroviral drugs / Biological markers / Biomarkers / Biomarkers - metabolism / C-Reactive Protein - metabolism / Care and treatment / Cell death / Chronic illnesses / Clinical trials / Collaboration / Cytokines / Cytokines - metabolism / Exercise / Health aspects / Heat shock proteins / Highly active antiretroviral therapy / HIV / HIV and co-infections / HIV infections / HIV Infections - diagnosis / HIV Infections - immunology / HIV patients / Human immunodeficiency virus / Humans / Hypoxia / IL-1β / Immune response / Infectious Diseases / Inflammation / Interleukin 6 / Internal Medicine / Lung - metabolism / Lung diseases / Lungs / Medical Microbiology / Medicine / Medicine & Public Health / Meta-analysis / Myocardium - metabolism / Oxidative stress / Oxygen consumption / Parasitology / Patients living with HIV / Physical activity / Physical exercises / Physical fitness / Physical training / Research Article / Resistance exercises / Retirement benefits / Risk factors / Systematic review / Tropical Medicine / Viruses