Divisao/Departamento de Molestias Infecciosas e Parasitarias, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Escola de Ciencias, Artes e Humanidades, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2021 Mar 24;76:e2457. doi: 10.6061/clinics/2021/e2457. eCollection 2021.
Comprehensive care for people living with human immunodeficiency virus (HIV) (PLH) includes the promotion of healthier habits, including physical activity (PA). This study aimed to describe a multicomponent pragmatic trial protocol to assess the effect of PA in preventing body changes and metabolic disturbances, improving the quality of life of PLH starting antiretroviral therapy (ART) and present cohort characteristics.
PLH undergoing ART for ≤4 months were recruited for a randomized trial. The intervention comprised three cardiorespiratory and/or strength training sessions per week at the clinic or in public spaces for 6 months under on-site or remote supervision, and educational sessions. Participants' PA levels, cardiorespiratory fitness, anthropometric measures, strength, flexibility, quality of life, and laboratory monitoring (blood glucose and lipids, CD4 counts) at baseline and post-intervention will be compared. The pragmatic design aims to enable the assessment of intervention effectiveness in real-life conditions.
At baseline, our cohort of 38 recently diagnosed patients (mean time since HIV diagnosis and duration of ART were 3 and 2.58 months, respectively) were predominantly male, young, with high schooling and good immune status (median CD4 count=498 cells/mm3). Twenty-two (57.9%) patients reported a PA below the World Health Organization recommendations. We found baseline normal anthropometric measures and metabolic parameters: below-average trunk flexion and elbow extension strength, poor handgrip strength and flexibility, and high quality of life scores in all except the physical domain.
Understanding how effective PA is in preventing body changes and metabolic disturbances, and in improving the quality of PLH starting ART may help establish guidelines to better incorporate PA in HIV care.
为艾滋病毒（HIV）感染者（PLHIV）提供全面护理，包括促进更健康的生活习惯，包括身体活动（PA）。本研究旨在描述一项多组分实用试验方案，以评估 PA 对预防身体变化和代谢紊乱、改善开始抗逆转录病毒治疗（ART）的 PLHIV 的生活质量的影响，并介绍队列特征。
招募正在接受 ≤4 个月 ART 的 PLHIV 参加一项随机试验。干预措施包括每周在诊所或公共场所进行三次心肺或力量训练，在现场或远程监督下进行 6 个月，以及教育课程。将比较参与者在基线和干预后的 PA 水平、心肺健康状况、人体测量指标、力量、柔韧性、生活质量和实验室监测（血糖和血脂、CD4 计数）。实用设计旨在评估干预措施在现实条件下的有效性。
在基线时，我们的队列包括 38 名新近诊断的患者（HIV 诊断后和 ART 开始时间分别为 3 个月和 2.58 个月），主要为男性，年轻，高学历，免疫状况良好（中位数 CD4 计数为 498 个细胞/mm3）。22 名（57.9%）患者报告的 PA 低于世界卫生组织的建议。我们发现基线的人体测量和代谢参数正常：躯干前屈和肘部伸展力量低于平均水平，手部握力和柔韧性差，除身体领域外，生活质量评分均较高。
了解 PA 在预防身体变化和代谢紊乱以及改善开始 ART 的 PLHIV 的生活质量方面的有效性，可能有助于制定更好地将 PA 纳入 HIV 护理的指南。
