Division of Infectious Diseases.
Division of Geriatric Medicine, Department of Medicine, School of Medicine.
AIDS. 2018 Oct 23;32(16):2317-2326. doi: 10.1097/QAD.0000000000001984.
Whether older people living with HIV (PLWH) can achieve similar functional benefits with exercise as their uninfected peers and the ideal intensity of exercise needed for these benefits are not known.
Sedentary adults (50-75 years) with or without HIV were recruited for 24 weeks of supervised endurance/resistance exercise. After 12 weeks of moderate-intensity exercise, participants were randomized to continue moderate-intensity or advance to high-intensity exercise for an additional 12 weeks.
Outcomes by serostatus and exercise intensity (moderate, high) were compared using linear and mixed effects regression models and controlled for baseline values or week 12 values.
A total of 32 PLWH and 37 controls were enrolled; 27 PLWH (12 moderate/15 high) and 29 controls (15 moderate/14 high) completed 24 weeks. PLWH had significantly poorer physical function across nearly all baseline measures. Both groups had significant improvements in all functional measures. From 0 to 12 weeks, PLWH had significantly greater percentage improvements (mean, 95% confidence interval) than controls on VO2 max [5 (0, 10)%]; from 13 to 24 weeks, PLWH had significantly greater percentage improvements on stair climb [-5 (-10, -1)%], and the time to complete a 400-m walk [-3 (-5, -0)%]; all P less than 0.05. An interaction between exercise intensity and HIV serostatus was significant for measures of strength: PLWH randomized to high-intensity gained significantly more strength than moderate-intensity in bench and leg press [6 (0, 12)% and 10 (2, 17)% greater; both P < 0.05]; controls had similar gains regardless of intensity.
Both moderate-intensity and high-intensity exercise resulted in significant improvements in physical function; high-intensity exercise may impart greater strength benefits to PLWH.
尚不清楚患有艾滋病病毒（HIV）的老年人（PLWH）是否可以像未感染的同龄人一样从运动中获得相似的功能益处，以及获得这些益处所需的理想运动强度。
招募了 50-75 岁的久坐成年人（有或没有 HIV）进行 24 周的监督耐力/阻力运动。在 12 周的中等强度运动后，参与者被随机分为继续中等强度运动或进一步增加至高强度运动 12 周。
使用线性和混合效应回归模型比较了不同血清状态和运动强度（中等、高强度）的结果，并控制了基线值或第 12 周的值。
共有 32 名 PLWH 和 37 名对照者入组；27 名 PLWH（12 名中等强度/15 名高强度）和 29 名对照者（15 名中等强度/14 名高强度）完成了 24 周的运动。PLWH 在几乎所有基线测量中均表现出较差的身体功能。两组在所有功能测量中均有显著改善。从 0 到 12 周，PLWH 在 VO2 max 上的改善百分比（均值，95%置信区间）显著高于对照组[5（0，10）%]；从 13 到 24 周，PLWH 在爬楼梯[-5（-10，-1）%]和完成 400 米步行的时间[-3（-5，-0）%]上的改善百分比显著更高；所有 P 值均小于 0.05。运动强度和 HIV 血清状态之间的交互作用在力量测量上有显著意义：随机分配到高强度运动的 PLWH 在 bench 和 leg press 上的力量增加显著高于中等强度运动[6（0，12）%和 10（2，17）%；均 P＜0.05]；而对照组无论强度如何，都有相似的收益。
中等强度和高强度运动都能显著改善身体功能；高强度运动可能会给 PLWH 带来更大的力量益处。
