“It’s been well documented that physical activity contributes to positive health outcomes in adults with HIV, but limited research has been done to see if an exercise treatment program can help children and adolescents who are HIV-infected,” said Tracie Miller, M.D., professor of pediatrics at the Miller School and lead author of the article titled “The effect of a structured exercise program on nutrition and fitness outcomes in human immunodeficiency virus-infected children.”
“We wanted to determine if a hospital-based exercise training program followed by a home-based program for children and adolescents with HIV is feasible and safe, and if it improves their fitness, strength and changes body composition.”
Children and adolescents with HIV are at risk for cardiovascular problems as a result of their highly active antiretroviral therapy, and a sedentary lifestytle may worsen their abnormal cardiovascular risk profiles. With HIV now considered a chronic illness, it has become more important to find safe and effective lifestyle interventions to reduce risks linked to long-term treatment.
Between 2001 and 2007, HIV-infected children who were 6 or older and followed by the University of Miami Pediatric Special Immunology and Adolescent Medicine Programs and the University of Rochester Pediatric HIV Program, were invited to participate in the nonrandomized exercise intervention study. The participants took part in 24 supervised exercise training sessions in a medical campus gym over a 12-week period; then they were prescribed an unsupervised home-based maintenance program.
Outcomes measurements included muscular strength/endurance, flexibility, aerobic fitness, body composition, and lipids. All 17 participants who completed the hospital-based intervention saw an improvement in their cardiovascular risk factors. The 12 participants who then went on to complete the home-based program were able to sustain their cardiovascular improvements.
“This is one of the first reports in kids with HIV infection that shows, given the right infrastructure, they can complete an exercise program and benefit from the intervention,” said Gwendolyn Scott, M.D., professor of pediatrics, director of the Division of Pediatric Infectious Diseases and Immunology, and an author of the study. “The results clearly show that working with them upfront in a structured environment helps them sustain the effort when they transition to a home-based exercise program.”
“Improving cardiac health in these children may be associated with enhanced quality of life, overall health, and school performance,” said Steven Lipshultz, M.D., professor and chairman of pediatrics and associate executive dean for pediatric health affairs at the Miller School. “The next steps will be to see if lifestyle interventions, such as exercise and physical activity, can positively affect these outcomes in children living with HIV and, if so, to make these interventions more widely available to children in the community.”
The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the Green Family Foundation and the Micah Batchelor Award for Research Excellence.