Evaluation of the effect of physical activity in the primary prevention of body changes and blood carbohydrate and lipid biochemistry, and on inflammatory markers, vascular function and QOL of PLWHA under highly active antiretroviral therapy

• Grant number: 13/20249-3
• Support type: Regular Research Grants
• Duration: July 01, 2014 - June 30, 2016
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal researcher: Aluisio Augusto Cotrim Segurado
• Grantee: Aluisio Augusto Cotrim Segurado
• Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Assoc. researchers: Alex Antonio Florindo ; Carlos Eduardo Negrão

Abstract

Major developments in the chemotherapy of HIV infection and aids, especially in relation to highly active antiretroviral therapy (HAART), have led to a significant increase in survival of HIV-infected individuals worldwide. However, adverse effects associated with therapy have been described in people living with HIV (PLWH) under HAART, especially central fat accumulation, which is a risk factor for chronic diseases, such as hypertension and type 2 diabetes. Associated dyslipidemia, peripheral insulin resistance and vascular dysfunction, can increase the risk of cardiovascular disease and death in this population. Studies have shown that physical activity helps decreasing body fat in PLWH under HAART. However, there is little evidence of the role of physical activity in the primary prevention of these changes. This study will evaluate the effects of physical activity as primary prevention on body composition changes and blood lipid and carbohydrate biochemistry, as well as the effect the intervention has on vascular function, blood concentrations of pro-inflammatory markers and quality of life of PLWH under HAART. This intervention study will consist of a randomized clinical trial involving patients followed up at Hospital das Clínicas, Faculty of Medicine, University of São Paulo - Emílio Ribas Institute. The sample is composed of 78 patients, divided into two groups of 39 people (intervention and control). Inclusion criteria are: 1) Ages between 18 to 59 years old at time of enrollment, 2) Being under HAART for at least three months at the date of enrollment; 3) Having waist circumference values under 102 cm for men and 88 cm for women. 4) Reporting being at least a month without physical activities in leisure, sport and exercise. The intervention group will be submitted to strength and cardio-respiratory training for six months under the supervision of physical education professionals. The main study variables will be anthropometric measures, body composition and quality of life. We will also evaluate vascular function, a marker of inflammatory activity, and metabolic data. At first, variables will be described in the two study groups (intervention and control) by means of central tendency (mean) and dispersion (standard deviations) measures. Comparison of means at two time points during intervention will be performed t-student test as necessary or Wilcoxon or Mann-Whitney as necessary. All analyses will be performed using the SPSS software, version 15.0. (AU)