# Exercise as it relates to Disease/The benefits of exercise in increasing strength and CD4 lymphocyte levels for HIV patients

The following review will analyse the journal article “Strength training improves body composition, muscle strength and increases CD4+ T lymphocyte levels in people living with HIV/AIDS” by Jose Garcia de Brito-Neto, et al published by peer reviewed online journals pagepress and endorsed by the University of Rio Grande do Norte State, Mossoro in Brazil.

## What is the background to this research?

Human Immunodeficiency Virus (HIV) is a disease that suppresses the body’s immune system and reduces the effectiveness of its ability to protect the body from various infections and diseases. Latest records on HIV cases in Australia have shown that in 2017 there were 27,545 people infected, which prompted interest in research for developing possible cures or ways to control the disease from manifesting. HIV is transmitted through the exchange of bodily fluids through sexual intercourse or sharing syringes with people infected with the virus. If left untreated it can potentially lead to the advanced stage of the virus known as Acquired Immune Deficiency Syndrome (AIDS).
| Asymptomatic | Symptomatic | AIDS |
| Normal physiological parameters (blood pressure, heart rate, VO2) | Increased heart rate at rest and submaximal work capacities | poor aerobic capacity |
| Functional aerobic impairments | aerobic and strength capacity reduced | damaged neuroendocrine responses to moderate/high intensity work rates |
| | fatigue easily to exercise programs | |
| | antiretroviral therapy side effects | |
There is no cure for HIV/AIDS, however there are antiretroviral medications that help patients live longer and minimise the risk of further HIV transmissions. In a recent study presented in the table above, it has shown that physical capabilities significantly reduce at progressed stages of the disease. This issue stimulates contemporary research in exercise maintenance of the HIV disease which can potentially help patients to live longer and healthier if they practice it daily.
Exercise has also been known to reduce the side effects of depression, improving energy levels and overall cardiovascular fitness. The purpose of this research article is to discover the effects of strength and conditioning exercises contributing to CD4+ lymphocyte levels which are responsible for protecting against infections and diseases. This review will examine the health benefits of physical activity and the reliability of the following journal article in contributing to contemporary HIV treatment research.

## Where is the research from?

This research was conducted by Jose Garcia de Brito-Neto in conjunction with nine other research affiliates. The research was endorsed by the university of Rio Grande do Norte State, Mossoro in Brazil. This is a reputable organisation to endorse the following research which includes reliable authors and their credentials in master’s of health and society combined with the nine other qualified health professional contributors to the study. Further to the above, it was reported that no conflict of interest was evident between the authors of this research article.

## What kind of research was this?

The research was conducted as a randomised controlled experiment. This involved two groups of test subjects being allocated at random to two different conditions and observing the result of each outcome. The research found in this article has proven to be similar to various other study results relating to immune system benefits.

## What did the research involve?

The two groups were randomly distributed to a physical activity treatment and the other being the control group receiving no exercise intervention, however both groups were treated with standard antiretroviral therapy. The physical activity group were assigned compound exercises such as bench press, lat pull down and leg press. Each compound lift was prescribed to the exercise group for 3 sets of 8-10 repetitions twice a week for a period of 12 weeks. Measures were taken to eliminate conflicting factors such as test subjects changing their lifestyle habits during the research period which creates bias in the results. The testing procedures undertaken consisted of various lean muscle, strength and blood extraction tests to determine the CD4+ lymphocyte count at the end of the testing period. These tests were completed before and after the testing period to observe changes. Limitations that were acknowledged in this study were a lack of resources to measure conflicting variables of nutrition intake, sleep time and hormone levels.

## What were the basic results?

The results that were found was an increase in lean body mass percentage and overall strength. Further to the above, it was found that the CD4+ lymphocyte levels had increased in the exercise intervention group more than the control group with no exercise intervention. From these results it was found that resistance training intensities are associated with elevating CD4+ levels in people who are living with HIV.

## What conclusions can we take from this research?

The findings of this research article have proven that Physical activity is a beneficial lifestyle choice for people living with the HIV disease because it promotes recruitment of infection fighting cells that protect the immune system from subsequent deterioration.
The outcomes of this research article aligns with similar studies conducted by Michael Freeman et al who discovered that suppression of inflammatory cytokines in the body known as the il-6 cytokine enables CD4+ t cells to restore and defend the body against opportunistic infections.
In addition to these findings, the supporting evidence from other research articles produced by Perez Chaparro et al has shown that resistance based physical activity reduces the il-6 cytokine levels in the body which are responsible for obstructing proliferation and recovery of CD4+ T cells. The fundamental research discovery in this article is the relationship between intensity and duration of physical activity which positively influences HIV control. These two components of exercise should be moderated in future studies to facilitate enhanced health benefits of treating HIV.

## Practical advice

It is important to consider that the experimental procedures conducted in this research article were monitored by health professionals and is difficult to safely reproduce for personal gain without qualified supervision. When diagnosed with HIV it is imperative to consult health professionals for correct exercise prescription because inaccurate prescription can potentially result in further harm than benefit. Due to the conditions of the HIV disease and the immune system complications that follow, it may further delay injury healing for extended periods of time. Careful progression of exercise intensities and monitoring safe work capacity for HIV infected individuals improves their overall health and prevents AIDS from developing.

## Further information/resources

For further information on HIV and the benefits of physical activity can be found in the following trusted links:
Exercise for People with HIV - https://www.hiv.va.gov/patient/daily/exercise/single-page.asp
Health Benefits of Exercise for People Living With HIV - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124952/
Physical activity, exercise and HIV - https://www.thewellproject.org/hiv-information/physical-activity-exercise-and-hiv

## Reference list

* ↑ Jose Garcia de Brito-Neto, et al (2019). Strength training improves body composition, muscle strength and increases CD4+ T lymphocyte levels in people living with HIV/AIDS. Infectious Disease Reports, 11(1).
* ↑ AIDSinfo. (2019). HIV/AIDS: The Basics Understanding HIV/AIDS. [online] Available at: https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/19/45/hiv-aids--the-basics [Accessed 18 Sep. 2019].
* ↑ Paynter, H. (2019). HIV Statistics - Australian Federation of AIDS Organisations. [online] Australian Federation of AIDS Organisations. Available at: https://www.afao.org.au/about-hiv/hiv-statistics/ [Accessed 18 Sep. 2019].
* 1 2 Health.nsw.gov.au. (2017). HIV infection fact sheet - Fact sheets. [online] Available at: https://www.health.nsw.gov.au/Infectious/factsheets/Pages/HIV-infection.aspx [Accessed 18 Sep. 2019].
* 1 2 Jaggers, J. and Hand, G. (2014). Health Benefits of Exercise for People Living With HIV. American Journal of Lifestyle Medicine, 10(3), pp.184-192.
* ↑ Aidsinfonet.org. (2019). Exercise and HIV | aidsinfonet.org | The AIDS InfoNet. [online] Available at: http://www.aidsinfonet.org/fact_sheets/view/802 [Accessed 18 Sep. 2019].
* ↑ Freeman M, et al (2016). Cytokines and T-Cell Homeostasis in HIV Infection. the journal of infectious diseases, 214(2), pp.51-57.
* ↑ Pérez Chaparro, et al (2018). Effects of aerobic and resistance exercise alone or combined on strength and hormone outcomes for people living with HIV. A meta-analysis. PLOS ONE, 13(9), p.e0203384.