Effects of exercise training on bone mineral density in adults living with HIV: a retrospective study.

Evidence on the effects of exercise training on the bone health of men and women living with HIV (MLHIV and WLHIV) is limited. To investigate the effects of a long-term multimodal exercise program on the bone mineral density (BMD) of MLHIV and WLHIV. A retrospective cohort of 39 patients (13 women; 48.4 ± 7.6 y; HIV-infection for 15.5 ± 6.5 y; combined antiretroviral therapy for 12.2 ± 7.0 y) performed a multimodal exercise program (60-min sessions of aerobic, resistance, and flexibility exercises performed 3 times/week for 9-106 months). MLHIV and WLHIV were allocated into groups showing either advanced osteopenia/osteoporosis or normal BMD (+ or -). MLHIV+ increased BMD at the femoral neck, total femur, and lumbar spine (∼3-4%) compared to MLHIV- ( ≤ 0.03). Changes in whole-body BMD were similar between MLHIV groups ( = 0.55). WLHIV+ exhibited higher loss of BMD at the femoral neck (∼6%) than WLHIV- ( = 0.04), whereas reductions in the whole-body, total femur, and lumbar spine (∼3-5%) were similar between groups ( ≥ 0.25). Among men, changes in femoral neck BMD were inversely correlated to femoral neck T-score (r = -0.62;  < 0.001), but not to the time of follow-up, appendicular skeletal muscle mass (ASM) index, or age ( ≥ 0.08). In women, these changes were inversely correlated with time of follow-up (r = -0.58) and age (r = -0.70) and positively correlated with femoral neck T-score (r = 0.46) and ASM index (r = 0.47) ( < 0.01). Multimodal exercise training may improve the BMD in people living with HIV, especially men with advanced osteopenia/osteoporosis. Adjuvant therapies to exercise should be considered to counteract losses in WLHIV.