HIV No Barrier to Aerobics

Adults with HIV are generally healthy enough to perform aerobic exercise, according to a literature review. But more stringently designed studies are needed to eliminate potential bias in findings.

The study conducted by Kelly K. O’Brien, PhD, BScPT, BSc, of the University of Toronto, and colleagues, was published on the BMC Infectious Diseases website on April 26, 2016.

The authors said the aim of the review was “to examine the safety and effectiveness of aerobic exercise interventions on immunological, virological, cardiorespiratory, strength, weight, body composition, and psychological outcomes in adults living with HIV.”

Although exercise is a an often-used strategy to improve health, the authors say “knowledge about the benefits and risks of exercise, and optimal parameters for exercise for adults living with HIV is still emerging.

There were 58 unique meta-analyses in their review showing “statistically significant improvements for outcomes of cardiorespiratory fitness, body composition, and psychological status,” according to the authors.,

But the researchers were frustrated in trying to make apples-to-apples comparisons of the findings. “The number of meta-analyses was limited due to variability in types of exercise interventions, level of exercise supervision, types of outcomes reported, and methodological quality, " they wrote.

They identified 24 studies--all randomized controlled trials-- that met their stated inclusion criteria, and assessed specific factors, including the immunological and viral outcomes, as well as some cardiorespiratory and strength measures. They also took BMI, weight, and psychological measures into account.

They did identify some possible biases. There was no way to assess selection bias in 54% of the studies that not describe the selection process.

The researchers also found there was a high risk for performance bias in 21 of the studies because the participants were not blinded to the intervention.

It was not clear in 19 of the 24 studies as to whether or not study personnel were blinded, leading to an unclear risk of detection bias, and there was a high rate of attrition bias in 67% of the studies selected.

Although the results of this review are consistent with previous results, the authors warn that the findings should be interpreted with caution due to the limitations and possible biases.

They suggest that future studies should “make efforts to include all participants in an ‘intent-to-treat’ analysis, blind assessor of outcomes, and include clinically meaningful and standardized outcomes to strengthen existing meta-analyses.”