Exercise may improve overall quality of life in people with HIV

September 2007

Patients with HIV who exercised at least twice per week improved their quality of life and their compliance with recommended medication regimens, according to data presented at the American Conference for the Treatment of HIV, held recently in Dallas.

Soula Fillipas, MPH, physiotherapist and senior clinician of infectious diseases at The Alfred in Melbourne, Australia, and colleagues analyzed 40 patients with HIV aged 18 and older who were randomly assigned to two exercise programs. The experimental group participated in a twice-weekly hour-long exercise program that consisted of aerobic and resistance exercise supervised by a physiotherapist. The control group participated in a home-based 20 minute walking program. The group also met twice weekly in a group forum supervised by a physiotherapist.

Seventeen of the 20 participants in the experimental group and 18 of the 20 participants in the control group completed the programs. Mean age for both groups was about 43 years. CD4 counts were 488 copies/mL in the experimental group and 419 copies/mL in the control group.

Adherence with HAART regimens was similar in both groups at baseline. At six months, the experimental group’s medication use using the Generic Self-Efficacy Scale was noted at a mean score of 35 out of 40 compared with the control group’s mean self efficacy at 31.

Quality of life was also improved in the experimental group. Significant improvements included cognitive function, fatigue, global health, health transition, mental health, pain, physician function, role function and social function.

“Self efficacy has been associated with better self-management skills in chronic illnesses and with better medication adherence,” Fillipas told Infectious Disease News.

Unmet exercise guidelines

In a related study also by Fillipas and colleagues, 191 patients with HIV and 70 participants without HIV aged 18 and older who attended The Alfred Infectious Diseases Clinic in late 2006, participated in a four-week study that measured prevalence of physical activity. The mean age among all participants was 43 years, and the majority of both groups were physically active men.

Data showed that patients with HIV exercised longer and more vigorously than participants without HIV (P<.05). Almost 75% of participants, regardless of HIV status, met current CDC and American College of Sports Medicine guidelines (at least 30 minutes of moderate-intensity physical activity on most days). However, 26.2% of patients with HIV reported minimal exercise, and 50 patients with HIV and 24 participants without HIV did not meet the CDC and American College of Sports Medicine guidelines.

“Supervised exercise programs should be considered to be standard care for patients with HIV,” Fillipas said. “Promotion of exercise and physical activity should be a priority for clinicians. Also, cost-effective programs based on prevention models of care should be a priority in the management of patients with HIV,” she said.

For more information:

• Fillipas S, Oldmeadow LB, Bailey MJ, Cherry CL. Participation in a supervised exercise program improves self-efficacy cardiovascular fitness and quality of life of people with HIV: A randomized controlled trial. #S5-3.
• Fillipas S, Bowtell-Harris CA, Cicuttini F, et al. Physical activity: Who does how much? #S5-2.
• Both presented at: the American Conference for the Treatment of HIV; May 31-June 3, 2007; Dallas.