LaPerriere A, Klimas N, Fletcher M A, Perry A, Ironson G, Perna F, Schneiderman N
Department of Psychiatry, University of Miami, Florida, USA.
Int J Sports Med. 1997 Mar;18 Suppl 1:S56-61. doi: 10.1055/s-2007-972700.
Growing evidence suggests that routine physical activity, by individuals who are HIV-1 infected, may have significant impact on several important components of good health. Some of the physical benefits noted are: an increase in cardiopulmonary fitness, improved muscle function, and weight gain, while psychological benefits consisting of improved mood states and increased active coping behaviors have been observed. However, the emphasis of this paper is on the effects of exercise training on the enumeration of CD4+ cells in HIV/AIDS. A review of all the available literature revealed: (1) no decline in CD+ cell counts seen in any of the studies, regardless of the initial stage of disease, level of CD4+ cells, or symptomatology; (2) a trend toward an increase in the number of CD4+ cells in all but one study, with the more significant increases seen in those subjects at earlier stages of disease; and (3) the importance of homogeneous study samples when investigating the effects of exercise in a dynamic disease, such as HIV/AIDS. With regard to possible mechanisms, psychological stress has been implicated among the cofactors contributing to the immunological decline in HIV-1 disease. Good evidence was presented which supports the stress management role of exercise training as a means to explain the buffering of these suppressive stressor effects, thereby facilitating a return of the CD4+ cell count to more normal levels. We therefore believe that the observed elevation in the number of CD4+ cells actually represents a normalization of CD4+ cells. With regards to practical application, collectively these studies provide reason to encourage HIV-1 infected individuals to begin an exercise training program, preferably while they are in the early stages of disease, and in compliance with the suggested guidelines.
越来越多的证据表明，感染HIV-1的个体进行日常体育活动可能会对健康的几个重要方面产生重大影响。已注意到的一些身体益处包括：心肺功能增强、肌肉功能改善和体重增加，同时还观察到了心理益处，如情绪状态改善和积极应对行为增加。然而，本文的重点是运动训练对HIV/AIDS患者CD4+细胞计数的影响。对所有现有文献的综述显示：（1）在任何研究中，无论疾病的初始阶段、CD4+细胞水平或症状如何，均未观察到CD+细胞计数下降；（2）除一项研究外，所有研究中CD4+细胞数量均有增加趋势，疾病早期阶段的受试者增加更为显著；（3）在研究运动对HIV/AIDS等动态疾病的影响时，同质研究样本的重要性。关于可能的机制，心理压力被认为是导致HIV-1疾病免疫功能下降的辅助因素之一。有充分证据支持运动训练在压力管理中的作用，以此来解释这些抑制性应激源效应的缓冲作用，从而促进CD4+细胞计数恢复到更正常的水平。因此，我们认为观察到的CD4+细胞数量增加实际上代表了CD4+细胞的正常化。关于实际应用，总体而言，这些研究为鼓励HIV-1感染个体开始运动训练计划提供了理由，最好在疾病早期阶段，并遵循建议的指导方针。
