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

Abstract

Background: Evidence on the effects of exercise training on the bone health of men and women living with HIV (MLHIV and WLHIV) is limited.

Objective: To investigate the effects of a long-term multimodal exercise program on the bone mineral density (BMD) of MLHIV and WLHIV.

Methods: 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 −).

Results: MLHIV+ increased BMD at the femoral neck, total femur, and lumbar spine (∼3–4%) compared to MLHIV− (p ≤ 0.03). Changes in whole-body BMD were similar between MLHIV groups (p = 0.55). WLHIV+ exhibited higher loss of BMD at the femoral neck (∼6%) than WLHIV− (p = 0.04), whereas reductions in the whole-body, total femur, and lumbar spine (∼3–5%) were similar between groups (p ≥ 0.25). Among men, changes in femoral neck BMD were inversely correlated to femoral neck T-score (r = −0.62; p < 0.001), but not to the time of follow-up, appendicular skeletal muscle mass (ASM) index, or age (p ≥ 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) (p < 0.01).

Conclusion: 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.

Keywords:

• AIDS
• osteopenia
• osteoporosis
• physical exercise

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was partially supported by the National Council for Technological and Scientific Development (CNPq) under Grant (303629/2019-3, recipient PF), Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro (FAPERJ) under Grants (E-26/110.184/2013, recipient PF; E-26/202.720/2019 and E-26/010.100935/2018, recipient JB), and Coordination for the Improvement of Higher Education Personnel (CAPES, process number 88882.463218/2019-01, recipient KGL).