The relationship between body composition and knee structure in patients with human immunodeficiency virus.

Obesity is a risk factor for osteoarthritis. Antiretroviral therapy (ART)-treated HIV-infected patients are frequently affected by overweight and obesity, and may be at increased risk of osteoarthritis. BMI however is a measure which does not discriminate adipose from non-adipose body mass, or fat distribution, which may have different effects. This study aimed to examine relationships between body composition and knee cartilage volume, as assessed by magnetic resonance imaging in HIV infection. 35 ART-treated HIV-infected men aged 51.7 years (mean) 7.9 (SD) and 18 healthy men aged 49.5 years (mean) 6.4 (SD) participated. Cartilage volume was measured on magnetic resonance imaging of the dominant knee using validated methods. Body composition was measured using dual x-ray absorptiometry. HIV-infected participants had less total body and gynoid fat (kg) (p = 0.04 and p = 0.007, respectively) and more percent android fat mass and percent trunk fat mass (p = 0.001 and p < 0.001, respectively) than controls. In HIV-infected participants there was an inverse association between total body fat mass and average tibial cartilage volume (R = -8.01, 95% CI -15.66, -0.36). Also, in HIV-infected participants there was an inverse association between android fat mass and average cartilage volume (R = -90.91, 95% CI -158.66, -23.16). This preliminary study found that both total body and android fat mass were inversely related to average knee cartilage volume in ambulant, ART-treated HIV-infected adults. These findings are features of early knee osteoarthritis and this may be of future significance in HIV.

The effects of exercise training on metabolic and morphological outcomes for people living with HIV: a systematic review of randomised controlled trials.

PURPOSE: to determine the effects of exercise on metabolic and morphological outcomes among people with HIV using a systematic search strategy of randomized, controlled trials (RCTs). METHODS: two independent reviewers assessed studies using a predetermined protocol. RESULTS: nine RCTs (469 participants, 41% females) of moderate quality were included. Compared to nonexercising controls, aerobic exercise (AE) resulted in decreased body mass index (weighted mean difference [WMD] -1.31; 95% CI, -2.59, -0.03; n=186), triceps skinfold thickness of subcutaneous fat (WMD -1.83 mm; 95% CI,-2.36, -1.30; n=144), total body fat (%) (standardised mean difference [SMD],-0.37; 95% CI, -0.74, -0.01; n=118), waist circumference (SMD -0.74 mm, 95% CI, -1.08, -0.39; n=142), and waist:hip ratio (SMD -0.94; 95% CI, -1.30, -0.58; n=142). Progressive resistive exercise (PRE) resulted in increased body weight (5.09 kg; 95% CI, 2.13, 8.05; n=46) and arm and thigh girth (SMD 1.08 cm; 95% CI, 0.35, 1.82; n=46). Few studies examined blood lipids, glucose, and bone density. CONCLUSIONS: few RCTs exist and their quality varies. AE decreases adiposity and may improve certain lipid subsets. PRE increases body weight and limb girth. No additional effects of combining AE and PRE are evident. Larger, higher quality trials are needed to understand the effects of exercise on metabolic outcomes (eg, lipids, glucose, bone density) relevant to persons with chronic, treated HIV.

Physical activity uptake in patients with HIV: who does how much?

Regular physical activity is recommended for patients with human immunodeficiency virus (HIV) to help manage their disease. However, to date, little is known about levels of uptake of this advice. This study describes daily physical activity in HIV antibody-positive patients attending a public hospital infectious diseases clinic, compares them with those of patients attending the clinic for general infectious diseases and investigates compliance with the recommendations of the Centres for Disease Control and Prevention and American College of Sports Medicine physical activity guidelines. During April 2006, 261 patients completed the International Physical Activity Questionnaire short form. One hundred and ninety-one reported being HIV antibody-positive. Results showed that 1:4 HIV antibody-positive and 1:3 HIV antibody-negative respondents failed to meet the recommended guidelines. These findings are of concern, given the evidence-based benefits of regular physical activity. Further work is needed to identify barriers to participation and interventions that can improve uptake.